This paper introduces a data warehouse model for outpatient payments, which is designed according to the requirements of the hospital financial management while dimensional modeling technique is combined with the analysis on the requirements. This data warehouse model can not only improve the accuracy of financial management requirements, but also greatly increase the efficiency and quality of the hospital management.
Ambulatory Care ; economics ; Databases, Factual ; Efficiency, Organizational ; Financial Management, Hospital

China ; Financial Management, Hospital ; Health Policy ; Hospital Administration ; economics ; education ; Hospital Information Systems ; Humans ; Problem Solving ; Quality of Health Care

Being aimed at the management of investment equipments, the flow of data has been put forward and the two main modes of data calculating have been established by our relying on No.1 Network of Military Healthy. The real-time management has been realized by the system in regard to eguipments' contact, charges, payouts, interest, payment, forecast and decision-makiing. It has been steadily test-running for more than 10 months in our hospital, and data have been processed exactly and creditably.
Computer Communication Networks ; Computer Simulation ; Computer Systems ; Cost-Benefit Analysis ; methods ; Equipment and Supplies, Hospital ; economics ; Financial Management, Hospital ; methods ; Software

PURPOSE: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. METHODS: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. RESULTS: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. CONCLUSION: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.
Chronic Disease* ; Classification ; Delivery of Health Care* ; Financial Management ; Health Services ; Humans ; Length of Stay ; Medicaid ; Medical Staff, Hospital ; Outpatients

PURPOSE: Homeless patients receive little or no social and medical concern because of their low economic status and the absence of responsible family, and no epidemiological reports have been performed on homeless patients so far. To establish medical politics for public welfare, We analyzed the homeless patients visiting our emergency department (ED). METHODS: A prospective descriptive study was accomplished for 215 homeless patients admitted at Chungnam National University Hospital 's emergency department from July 1998 to June 2000. We investigated them in terms of age, sex, length of stay, diagnosis, level of consciousness, payment, sobriety, and admission. RESULTS: A total 215 patients were enrolled (males:190, 88%). The fifth decade, 74 patients, was the largest age group (34.4%), followed by the sixth decades, 58 patients (27.0%). The largest groups for length of stay and final diagnosis were 101 for stays from 7 to 24 hours (47.0%) and 80 for alcoholism (37.2%). Fifth and sixth alcoholism patients were 55 of 80 (68.8%). Drunken patients were 132 of the total (61.4%). Alcoholism seemed to be the main cause of unconsciousness on ED admission as 67 of the 80 alcoholism patients were unconscious. No medical payment could be taken from the emergency medical fund. The local public welfare department accepted responsibility for payment from the local budget. CONCLUSION: Most homeless patients were in their fifth and sixth decades and had Problems with alcohol and medical payment. That is why they could not get the appropriate medical service. Further social and medical concerns are warranted for their health, and more investigations should be performed from a medical point of view, not a socialwelfare one.
Alcoholism ; Budgets ; Chungcheongnam-do ; Consciousness ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Financial Management ; Humans ; Length of Stay ; Politics ; Prospective Studies ; Unconsciousness

PURPOSE: The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. METHODS: Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. RESULTS: After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. CONCLUSIONS: The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurse.
Adult ; Education, Nursing, Continuing/*methods ; Financial Management/*methods ; Focus Groups ; Humans ; Middle Aged ; *Needs Assessment ; *Nurses ; Nursing Staff, Hospital/*education ; Republic of Korea

PURPOSE: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. MATERIALS AND METHODS: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. RESULTS: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). CONCLUSIONS: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.
Busan ; Compliance ; Dissent and Disputes ; Financial Management, Hospital ; Health Personnel ; Humans ; Male ; Malpractice ; Medical Errors ; Medical Records ; Negotiating ; Retrospective Studies ; Risk Factors

BACKGROUND: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. MATERIAL AND METHOD: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. RESULT: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups. Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p < 0.01) and ventilator support time(14.9 vs 56.2 hours, p < 0.01) were significantly shorter in the OPCAB group. Total hospital costs were 17,220,000 and 21,250,000(Korean Won) in group I and II , respectively(p < 0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. CONCLUSION: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.
Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Fees and Charges ; Financial Management ; Hospital Charges ; Hospital Costs ; Humans ; Critical Care ; Length of Stay ; Mortality ; Perioperative Care ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ventilators, Mechanical

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography

PURPOSE: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. METHODS: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. RESULTS: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. CONCLUSION: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.
Consensus ; Fees and Charges* ; Financial Management ; Health Expenditures ; Hospital Charges ; Hospitalization ; Hospitals, General ; Humans ; Insurance, Health ; Jurisprudence ; Methods ; National Health Programs* ; Nurse-Patient Relations ; Nursing Administration Research ; Nursing Staff ; Nursing* ; Public Opinion ; Tertiary Care Centers