OBJECTIVES: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. METHODS: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. RESULTS: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. CONCLUSIONS: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.
Adolescent ; Adult ; Ambulatory Care/*economics/statistics & numerical data ; Cesarean Section/*economics/statistics & numerical data ; Diagnosis-Related Groups/*economics/statistics & numerical data ; Fee-for-Service Plans/*economics/statistics & numerical data ; Female ; Humans ; Insurance Claim Review ; Length of Stay/*economics/statistics & numerical data ; Middle Aged ; Pregnancy ; Young Adult

Purpose: The purpose of this study was to investigate the knowledge, awareness and performance of COVID-19 infection control among physical therapists and to identify the impact factors on performance Methods: Data were collected from March 16th to March 24th in 2022 from the physical therapist’s in Busan. Data analysis was conducted on 170 surveys, after excluding 27 surveys that were found to be unsuitable for data analysis. Results When correlating the study variables, knowledge and awareness were found to have a positive, meaningful correlation with performance. Performance of COVID-19 personal infection control regression analysis showed that the working department (clinic and long-term care hospital), clinical experience, the more knowledgeable, the awareness (personal), and the more clinical experience had significant positive impacts on the performance of COVID-19 infection control. Performance of COVID-19 treatment room infection control regression analysis showed that the working department (long-term care hospital), educational experience, the awareness (treatment room) had significant positive impacts on the performance of COVID-19 infection control Conclusion: The results of this study may be used as basic data for educating physical therapist’s working at the COVID-19 response department. This study suggests that physical therapist’s need educational programs to improve their knowledge and awareness and performance of infection control against infectious diseases such as COVID-19. Differentiated physical therapists practice education curricula must be developed and provided after understanding the varying characteristic of physical therapist’s with different levels of work experience.

OBJECTIVES: This study aimed to examine the changes in health outcomes and the patterns of medical institution utilization among patients with long-term stays in public hospitals following the closure of a public medical center. It also sought to present a proposal regarding the role of public hospitals in countries with healthcare systems predominantly driven by private entities, such as Korea. METHODS: To assess the impact of a public healthcare institution closure on health outcomes in a specific region, we utilized nationally representative health insurance claims data. A retrospective cohort study was conducted for this analysis. RESULTS: An analysis of the medical utilization patterns of patients after the closure of Jinju Medical Center showed that 67.4% of the total medical usage was redirected to long-term care hospitals. This figure is notably high in comparison to the 20% utilization rate of nursing hospitals observed among patients from other medical facilities. These results indicate that former patients of Jinju Medical Center may have experienced limitations in accessing necessary medical services beyond nursing care. After accounting for relevant mortality factors, the analysis showed that the mortality rate in closed public hospitals was 2.47 (95% confidence interval, 0.85 to 0.96) times higher than in private hospitals. CONCLUSIONS The closure of public medical institutions has resulted in unmet healthcare needs, and an observed association was observed with increased mortality rates. It is essential to define the role and objectives of public medical institutions, taking into account the distribution of healthcare resources and the conditions of the population.