• Journal of Society of Preventive Korean Medicine
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• v.20 no.2
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• pp.27-38
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• 2016

Backgrounds : Taiwan has similar national health insurance (NHI) system for traditional medicine with South Korea. Recently, new quality improvement policies for traditional medicine is being attempted in Taiwan. Objectives : This study aimed to review the Taiwanese NHI system for Chinese Medicine (CM) and introduce quality improvement policies. Methods : Research articles, reports, government publications and year books which handled traditional medicine system and NHI system in Taiwan were searched and collected. The authors analyzed and summarized the contents in a qualitative manner. Results : In Taiwanese NHI system, CM procedures and medication for outpatients are reimbursed through a mix of fee-for-service and global budget payment system. CM shares 4% of total expenditure of NHI in Taiwan. Mostly, the expenses for procedures are reimbursed regardless of disease type, however, in the specialized program for quality improvement, CM doctors have to comply with standard operating procedures (SOPs). Conclusions : Taiwanese NHI system implemented SOP-based new reimbursement system for CM. Yet, the scientific evidences for SOPs are not sufficient, it can be useful references when we develope disease related reimbursement system for Korean Medicine in South Korea.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.28-31
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• 2002

Filmless full-PACS in korea has rapidly been growing, since government had supported collaborative PACS project between industry and university hospital in late of 1995. At the same time, a small company had started PACS business, while the Korea PACS society was being formed. In the beginning, PACS societies had focused on developing peripheral solutions such as DICOM gateway for image acquisition, x-ray film digitizer, and viewing software for research or management of personal image data, while Samsung Medical Center had started installing an imported partial PACS system which had recently upgraded with a new system. In similar time frame, a few hospitals had started developing and installing domestic large scale full-PACS system. Several years later, many hospitals have installed full-PACS system with national policy of reimbursement for PACS exams in November 1999. It is believed that Korea is the first country that adopted PACS reimbursement for filmless full-PACS as a national policy. Both experiences of full-PACS installation and national policy generated tremendous intellectual and technological expertise about PACS at all levels, clinical, hospital management, education, and industrial sectors. There are currently three types of PACS system which includes domestic, imported, and hybrid PACS system with imported solution for core system and domestic solution for peripheral system. There are more than 20 domestic PACS companies and they have now enough experiences so that they are capable of installing a truly full-PACS system for large-scale teaching hospitals. PACS societies in Korea understand how to design, implement, install, manage, sustain, and provide good services for large-scale full-PACS. PACS society has also strength for the highest integration technology of the Hospital Information. However, further understanding and timely implementation of continuously evolving international standard and integrated healthcare enterprise concepts may be necessary for international leading of PACS technologies for the future.

• 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.

• Journal of the Korea Society of Computer and Information
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• v.25 no.5
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• pp.209-216
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• 2020

As depository system for negotiation or reimbursement to the victim in criminal case is reflected to consideration for diminishing punishment and hence, it is very important in the process. According to the current law, one needs to fill out victim's personal information such as name, address, and ID number for processing depository. However, if the victim is sexual violence victim, all the personal information is covered up becoming anonymous. Therefore, it becomes difficult for the accused person to get necessary information. Such covering up action is to prevent further second damage that may be caused such as threatening for the negotiation whereas victim has no willingness to forgive the accused. However, even if the accused person regrets his/her crime and make reimbursement to the victim, as they have no personal information on the victim it becomes impossible for them to make the depository. If we apply ESCROW system here it will allow victims to avoid any direct contact with the accused person as well as preventing any privacy disclosure. Also, for the accuse person, they can show how much they regret by making depository within their capability.

• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.141-148
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• 2021

There are very scant data on the epidemiology of primary immunodeficiency diseases (PIDs) in Korea. Here we attempted to estimate the PID epidemiology and disease burden in Korea. A systematic review was performed of studies retrieved from the PubMed, KoreaMed, and Google Scholar databases. Studies on PIDs published in Korean or English between January 2001 and November 2018 were analyzed. The number of PID patients and the healthcare costs were estimated from Health Insurance Review and Assessment Service (HIRA) Korea data for 2017. A total of 398 PID patients were identified from 101 reports. Immunodeficiencies affecting cellular and humoral immunity were reported in 11 patients, combined immunodeficiency with associated or syndromic features in 40, predominantly antibody deficiencies in 144, diseases of immune dysregulation in 58, congenital defects of phagocytes in 104, defects in the intrinsic and innate immunity in 1, auto-inflammatory disorders in 4, complement deficiencies in 36, and phenocopies of PID in none. From the HIRA reimbursement data, a total of 1,162 outpatients and 306 inpatients were treated for 8,166 and 6,149 days, respectively. In addition, reimbursement was requested for 8,200 outpatient and 1,090 inpatient cases and $1,924,000 and $4,715,000 were reimbursed in 2017, respectively. This study systematically reviewed published studies on PID and analyzed the national open data system of the HIRA to estimate the disease burden of PID, for the first time in Korea.

• Health Policy and Management
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• v.32 no.2
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• pp.125-136
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• 2022

The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Health Policy and Management
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• v.33 no.4
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• pp.400-410
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• 2023

Background: As the government has recently been discussing the expansion of the disaster health expenses support project, we would like to confirm the characteristics of beneficiaries of the support project, particularly those of high-cost beneficiaries. Methods: Using the database of catastrophic health expenditure support project from 2019-2020, this study aims to confirm the characteristics of high-cost beneficiaries focusing on the overlap of the relieved out-of-pocket systems, known as the out-of-pocket ceiling system and the system for rare incurable diseases. Logistic regression analysis is used to examine this issue. Results: In order to analyze the factors influencing high-cost beneficiaries, five models were created and analyzed, including the status of duplicated beneficiaries for relieved out-of-pocket systems, sociodemographic and economic factors, and individual health status as sequential independent variables. All five models were statistically significant, of which economic factors had the greatest impact on the model's predictions. The main results indicated that those who benefited from multiple systems in duplicate were more likely to be high-cost beneficiaries, and there is a higher probability of incurring high health expenses among the underage. In addition, within the beneficiaries of catastrophic health expenditure support project, it was observed that higher health insurance premium percentiles are associated with a higher proportion of high-cost beneficiaries. Conclusion: This study examined the characteristics of high-cost beneficiaries by encompassing reimbursement and non-reimbursement. According to this study, it is expected to be used as basic data for setting priorities and improving the current criteria of catastrophic health expenditure support project, aiming to sequentially expand the program.

• International Commerce and Information Review
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• v.12 no.2
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• pp.213-237
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• 2010

Duty refund taken exports of raw materials in the manufacture of goods for import duties paid, and refunds, as a system, enhance the price competitiveness of domestic exporters to promote exports is established for them. The duty drawback system is consumed in the production of export goods levied on imported inputs does not exceed the level of reimbursement is established within the WTO rules do not restrict the export support policy is one of. Korea-EU FTA negotiations is a drawback in the ongoing maintenance of claims, while the EU claims that the duty drawback system can not be negotiated until the end of the field of focus is discussed. Intermediate goods imports to Korea is a higher percentage was pointed out the importance of duty drawback, EU FTA, the duty drawback is not a party to remain exporters of raw materials, such as 3rd party can not go back because the benefits were opposed to. The final one-EU Concessions for the current duty drawback system was to maintain continuous.

• Journal of Engineering Education Research
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• v.14 no.3
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• pp.61-71
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• 2011

Korea has introduced the levy-grand system in the vocational learning finance. The standard unit price system of training cost was utilized in the distribution of training budget and the reimbursement system including total or partial training cost return has been operated in the corporate training after completing the learning course particularly. The standard unit price was calculated in the base of analyzing on supporting budget by the government per training institutions and corporate payment decision to learning institutions. The proposing standard unit price system of training cost was analyzed in the current standard price unit of training cost and then an improvement policy and the implication are derived from it. At the result of this study, the current government supporting level to e-learning and postal distance learning indicates good status.

• Quality Improvement in Health Care
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• v.12 no.2
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.