• Journal of Convergence for Information Technology
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• v.12 no.2
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• pp.184-191
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• 2022

This study aims to provide basic information necessary to find an efficient management plan for patients using auto insurance. The analysis was conducted on the five-year auto insurance medical expenses review data registered in the health care bigdata Hub from 2016 to 2020. As a result of the analysis, the number one composition ratio of auto insurance inpatient treatment expenses was treatment and surgery fees for Certified tertiary hospitals, hospitalization fees for general hospitals, hospitals and clinics, and treatment and surgery fees for oriental medical institutions and dental hospitals. outpatient treatment expenses was doctor's fee for medical institution, treatment and surgery fees for oriental medical institutions and dental hospitals. The ratio of medication, anesthesia, and special equipment significantly affected the cost of inpatient. And the ratio of physical therapy significantly affected the cost of outpatient.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.247-253
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• 2018

Background: Early extubation after cardiovascular surgery has some clinical advantages, including reduced hospitalization costs. Herein, we review the results of ultra-fast-track (UFT) extubation, which refers to extubation performed on the operating table just after the operation, or within 1-2 hours after surgery, in patients with congenital cardiac disease. Methods: We performed UFT extubation in patients (n=72) with a relatively simple congenital cardiac defect or who underwent a simple operation starting in September 2016. To evaluate the feasibility and effectiveness of our recently introduced UFT extubation strategy, we retrospectively reviewed 195 patients who underwent similar operations for similar diseases from September 2015 to September 2017, including the 1-year periods immediately before and after the introduction of the UFT extubation protocol. Propensity scores were used to assess the effects of UFT extubation on length of stay (LOS) in the intensive care unit (ICU), hospital LOS, and medical costs. Results: After propensity-score matching using logistic regression analysis, 47 patients were matched in each group. The mean ICU LOS ($16.3{\pm}28.6$ [UFT] vs. $28.0{\pm}16.8$ [non-UFT] hours, p=0.018) was significantly shorter in the UFT group. The total medical costs ($182.6{\pm}3.5$ [UFT] vs. $187.1{\pm}55.6$ [non-UFT] ${\times}100,000$ Korean won [KRW], p=0.639) and hospital stay expenses ($48.3{\pm}13.6$ [UFT] vs. $54.8{\pm}29.0$ [non-UFT] ${\times}100,000KRW$, p=0.164) did not significantly differ between the groups. Conclusion: UFT extubation decreased the ICU LOS and mechanical ventilation time, but was not associated with postoperative hospital LOS or medical expenses in patients with simple congenital cardiac disease.

• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.105-116
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• 2021

Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

• Health Policy and Management
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• v.34 no.1
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• pp.68-77
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• 2024

Background: Depressive disorders can be categorized into daily depression and clinical depression. The experience of depressive disorder can increase health care utilization due to decreased treatment compliance and somatization. On the other hand, the clinical depression group may also experience social prejudice associated with the illness, which can limit their access to health care utilization. In terms of the significance of health care utilization as a factor in individual and social issues, this study aims to compare the health care utilization of the clinical depression group with that of the non-depressed group and the daily depression group. Methods: The analysis utilized the inverse probability of treatment weighting based on the generalized propensity score. Results: As a result of the analysis, clinical depression and daily depression were higher among women, low-income groups, individuals with low education levels, and so forth. The clinical depression group was also higher among individuals who were not economically active, did not have private health insurance, or had multiple chronic diseases. The number of outpatient department visits in the depression group was significantly higher than in the non-depressed group. In addition, the number of outpatient department visits for the clinical depression group was significantly higher than that for the daily depression group. Outpatient medical expenses were higher in the depression group than in the non-depressed group, and there was no significant difference between the clinical depression group and the daily depression group. Conclusion: Health care utilization was higher in the depression group than the non-depressed group, it was also higher in the clinical depression group than the daily depression group.