OBJECTIVE: The aims of this study were to quantify the costs of treatment in patients with schizophrenia and to compare the cost according to the relapse status. METHODS: A total of 330 patients were consecutively enrolled from 11 hospitals in Korea. Differences in direct medical costs by relapse status in the 6 months were examined. RESULTS: The medical cost in patients with relapse was about seven times higher than the cost in patients without relapse. The cost for hospitalization largely accounted for the cost in patients who relapsed. The most common reason for the hospitalization in patients with relapse was poor drug compliance. CONCLUSION: Relapse in patients with schizophrenia significantly increases medical costs in Korea.
Direct Service Costs ; Hospitalization ; Humans ; Korea ; Recurrence ; Republic of Korea ; Schizophrenia

OBJECTIVES: To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. METHODS: The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. RESUJLTS: The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I,IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses, 453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). CONCLUSIONS: The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.
Adult ; Ambulatory Care ; Daegu ; Direct Service Costs ; Hospitals, General ; Humans ; Hypertension ; Insurance ; Insurance, Health ; Prescriptions* ; Public Health

OBJECTIVES: To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. METHODS: The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. RESUJLTS: The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I,IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses, 453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). CONCLUSIONS: The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.
Adult ; Ambulatory Care ; Daegu ; Direct Service Costs ; Hospitals, General ; Humans ; Hypertension ; Insurance ; Insurance, Health ; Prescriptions* ; Public Health

OBJECTIVES: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. METHODS: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. RESULTS: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. CONCLUSIONS: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.
Adult ; Ambulances ; Direct Service Costs ; Emergency Service, Hospital/*economics/*statistics & numerical data ; *Fees and Charges ; Female ; Humans ; Male ; Middle Aged ; Regression Analysis ; Time Factors

PURPOSE: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. MATERIALS AND METHODS: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. RESULTS: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. CONCLUSION: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.
Amputation ; Arteries ; Diabetic Foot ; Direct Service Costs ; Fees and Charges ; Foot ; Home Care Services ; Humans ; Inpatients ; Length of Stay ; Lower Extremity ; Medical Records ; Outpatients ; Tertiary Care Centers