• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.78-99
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• 2000

Objectives: The purpose of this study was to evaluate the opinions of hospital managers on DRG pilot study. Methods: Managers of 800 hospitals which had participated in DRG pilot study during the period 1997-1999, were requested to respond to structured self-administerd questionnaire. The questionnaire was composed with six categories: the motivation and satisfaction for the DRG pilot study, the opinions on the level of unit price, the appropriateness of DRG classification, the change of medical service quality during the pilot study, the patient's complains resulted from DRG system. and the opinions on the nation-wide application of DRG system. Results : Of the 800 subjects, 327(clinic, 210: 25 hospitals, 82 general hospitals, and 16 tertiary hospitals) completed the questionnaire, and the overall response rate was 41%, 121 hospitals(27%) answered that they participated in DRG pilot study because of convenience of claims and 118 hospitals(35%) dissatisfied with DRG system. 251 hospitals(85%) thought that the level of unit price under the DRG system was same as or lower than that of fee-for service. 297 hospitals(92%) responded that DRG classification should be modified and 137 hospitals(47%) experienced deterioration of medical service quality during the DRG pilot study. The 116 hospitals(35%) experienced the patient's complains resulted from DRG system. The 85 hospitals(88%) didn't want nation-wide application of DRG system. Conclusion: Most of the responded managers seemed to have negative opinions on DRG pilot study, even though they had been participated voluntarily. Further studies and extensive evaluations of DRG reimbursement system are needed before nation-wide application.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.36-61
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• 2009

This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

• Korea Journal of Hospital Management
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• v.12 no.3
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• pp.1-19
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• 2007

This study focused on finding the variation of medical service utilization and medical payments of the patients died by three, cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of slays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, were matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follow. The variation of medical service utilization of the dead by cancers were not small in Korea. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that tile factors of suppliers and utilizers should he reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could he recommended to reduce the high variation of medical service Use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.

• Korean Journal of Community Nutrition
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• v.17 no.2
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• pp.182-193
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• 2012

The purpose of this study was to investigate the current status of food service management in the restaurants participating in the government-funded children's meal program during summer vacation. A mail survey was conducted with individuals who worked in the restaurants participating in the government-funded children's meal program in Seoul during the summer vacation in 2010. A total of 600 questionnaires were distributed to 274 Chinese, 235 Bunsik and 91 Korean restaurants, which were selected using proportionate stratified sampling by regions and types of operations. A total of 138 usable questionnaires (23.0%) were returned and analyzed. The results showed that over half (57.2%) of the restaurants did not employ any certified cooks. Most of the restaurants (97.8%) provided side dishes; among them, only 42% planned menus for side dishes in advance and only a half changed side dish menus periodically. The suggested reasonable reimbursement rate per meal for children using restaurants differed by types of restaurants; the percentage of restaurants having responded 5,000 won or higher was the highest in Chinese restaurants. This study revealed that food service in the restaurants participating in the government-funded children's meal program was not properly managed during summer vacation, especially in terms of menu and food production. This study also showed that the suggested reasonable reimbursement rate of meals for children using restaurants differed by types of restaurants, implying that adjusting the reimbursement rate according to types of restaurants should be considered in the government-funded children's meal program.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.51-65
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• 1996

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance. From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we devided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in Korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in Korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be needed to reduce hospital cost in Korea. We thought that the Korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the United States. This study presents some limitations such as no insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can. possibly affect LOS. However, this study reports an important trend in LOS from 1984 to 1994.

• 대한예방의학회:학술대회논문집
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• 1999.10a
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• pp.37-38
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• 1999

• 대한예방의학회:학술대회논문집
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• 1993.10a
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• pp.157-158
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• 1993

• International Commerce and Information Review
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• v.11 no.3
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• pp.287-309
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• 2009

There were many changes regarding Negotiation of document under UCP 600. First of all, the definition of Negotiation was changed. The UCP 500 stated "Negotiation means the giving of value for drafts and documents by the bank authorized to negotiation", but the UCP 600 defines "negotiation" as following "negotiation means the purchase by the nominated bank of drafts and/or documents under a complying presentation". Under the UCP 600 the meaning of negotiation was more clear than UCP 500. Second UCP 600 permits all deferred payment credits be discountable or negotiable. This amended rule equated the deferred payment credit with banker's acceptance credit which was contrary with the nature and the practice of former deferred payment credit transaction. Third, UCP 600 has also provided for reimbursement rights for nominated banks and a conceptual basis for protecting nominated banks against beneficiary fraud. In this paper, the problems regarding negotiation of document under UCP600 was studied and the solutions for the problems occurring in appling UCP 600 in practical field was provided.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3785-3792
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• 2013

This study aimed to discover to what extent ethical issues are considered in the reimbursement decision process based on health technology assessment (HTA) in Korea, especially for oncology medications. Public summary documents (PSDs) published by the Health Insurance Review and Assessment Service (HIRA) were analyzed for empirical and normative factors. For external comparison, PSDs presented by corresponding institutions of Australia and the United Kingdom were employed. Furthermore, the opinions of eight expert oncologists were obtained regarding the accountability of the evidence in PSDs. Among 7 oncology drugs, there were differences in the final decisions and empirical factors considered, such as selected comparators and interpretation of evidence between the PSDs from the three institutions. From an ethical viewpoint, the following matters were deficient in the HTA decision-making process for oncology drugs: clear and reasonable standards; identifying and evaluating ethical values; and public accountability for reasonableness about decisions and due process.

• Korea Journal of Hospital Management
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• v.14 no.4
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• pp.52-70
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• 2009

This study is to analyse the reimbursement prices of drugs in Japan. Japan has the world's second-largest pharmaceutical market, and the world's largest price-controlled pharmaceutical market. The reimbursement prices of new drugs in Japan are determined by confidential negotiations between the manufacturer and the Japanese Ministry of Health, Labor, and Welfare. Pharmaceuticals account for a larger share of total healthcare expenditures in Japan than in most other major pharmaceutical markets such as France, Germany, United Kingdom and United States. Prescription drugs' share of total healthcare spending has slightly increased in recent years, from 20.2% in 2000 to 21.5% in 2004, the most recent year for which data are currently available. This trend is attributable to the effect of the Japanese rapidly aging population that stimulates demand for healthcare services. There are several method of price setting for drugs as below. First, on the initial pricing of branded drugs, is the similar-efficacy pricing method and cost calculation method. Second is postmarketing price changes which are biennial price revisions under the rule of National Health Insurance. Third is the rule of the generics price. Recently, the generics market is expanded because there are increasing numbers of hospitals by DPCs(Diagnosis-procedure Combinations).