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

PURPOSE: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. METHODS: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in ‘Public Hospitals Alert’, was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. RESULTS: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as ₩29,128 The nursing cost per inpatient per day was calculated as ₩157,970, and the administration cost per patient was calculated as ₩133,710. CONCLUSION: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.
Budgets ; Cost Allocation ; Costs and Cost Analysis ; Health Care Costs ; Hospital Costs ; Hospitals, Public ; Humans ; Inpatients ; Methods ; Nursing Services ; Nursing*

Drug Costs ; Ethics, Medical ; Health Care Costs ; Health Services Accessibility ; Humans ; Models, Economic ; Morals ; Physicians ; ethics ; Singapore ; United Nations

PURPOSE: The purpose of this study was to evaluate the cancer care cost during the last year of life of patients in Korea. MATERIALS AND METHODS: We studied the breakdown of spending on the components of cancer care. Cancer decedents in 2009 were identified from the Korean Central Cancer Registry and linked with the Korean National Health Insurance Claims Database. The final number of patients included in the study was 70,558. RESULTS: In 2009, the average cancer care cost during the last year of life was US $15,720. Patients under age 20 spent US $53,890 while those 70 or over spent US $11,801. Those with leukemia incurred the highest costs (US $43,219) while bladder cancer patients spent the least (US $13,155). General costs, drugs other than analgesics, and test fees were relatively high (29.7%, 23.8%, and 20.7% of total medical costs, respectively). Analgesic drugs, rehabilitation, and psychotherapy were still relatively low (4.3%, 0.7%, and 0.1%, respectively). Among the results of multiple regression analysis, few were notable. Age was found to be negatively related to cancer care costs while income level was positively associated. Those classified under distant Surveillance, Epidemiology, and End Results stages of cancer and higher comorbidity level also incurred higher cancer care costs. CONCLUSION: Average cancer care costs varied significantly by patient characteristics. However, the study results suggest an underutilization of support services likely due to lack of alternative accommodations for terminal cancer patients. Further examination of utilization patterns of healthcare resources will help provide tailored evidence for policymakers in efforts to reduce the burdens of cancer care.
Analgesics ; Comorbidity ; Delivery of Health Care* ; Drug Costs ; Epidemiology ; Fees and Charges ; Health Care Costs ; Humans ; Korea ; Leukemia ; National Health Programs ; Psychotherapy ; Rehabilitation ; Terminal Care ; Urinary Bladder Neoplasms

A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of healt expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical data. Finally, the difference in parameters between the two estimations were explained through residual analysis.
Health Care Costs ; Health Expenditures*

PURPOSE: Under the rising demand of health services, the critical pathway (CP) which standardizes the practice guideline was introduced as a means to provide quality healthcare service. CP may increase the patient's satisfaction rate by providing systematic and consistent service. We aimed to evaluate the significance of CP by development and application of CP to patients undergoing laparoscopic cholecystectomy. METHODS: From June 2010 to July 2011, 148 patients underwent elective laparoscopic cholecystectomy. Patients were divided into two groups, including 57 patients in the CP group and 91 patients in the non-CP group. In a retrospective review, related hospital costs were analyzed and compared for both groups. Survey results on satisfaction for the CP group were also analyzed. RESULTS: The mean age was 22.7 years in the CP group and 37.9 years in the non-CP group. Number of hospitalized days was one day for the CP group and 2.51 days for the Non-CP group with p<0.001. In cost analysis all variables showed a significant reduction in the CP group compared to the Non-CP group. The satisfaction rate in the CP group scored 8 points out of 10. CONCLUSION: Results have shown benefit from the financial point of the view for the CP group. Current inclusion criteria for CP are limited and still in development for a solid protocol. Further efforts with a large-scale comparative study to broaden the indication for CP are desired.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Costs and Cost Analysis ; Critical Pathways* ; Delivery of Health Care ; Health Services ; Hospital Costs ; Humans ; Retrospective Studies

OBJECTIVETo investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics.

METHODSA total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year (from November 2009 to November 2010) were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed.

RESULTSThe average annual drug cost in hypertension was (621.50 ± 1337.78) yuan per patient; while the cost was (616.13 ± 1248.40) yuan in management group and (626.44 ± 1414.30) yuan in control group respectively. The average annual drug cost of hypertensive patients who took medicine therapy was (702.05 ± 1401.79) yuan per person, while the cost in the management group ((688.50 ± 1300.70) yuan) was much lower than it in control group ((714.64 ± 1489.60) yuan). The annual average drug cost in urban was (731.88 ± 1403.31) yuan per person, which was higher than it in rural as (407.44 ± 1171.44) yuan per person. The average hospitalized rate was 12.2% (1014/8326), and the average annual cost among the hospitalized patients was (9264.47 ± 18 088.49) yuan per person; while the cost was (7583.70 ± 13 267.00) yuan in management group, which was lower than it in control group as (11 028.00 ± 21 919.00) yuan. The average annual hospitalized cost in hypertension was (1064.87 ± 6804.83) yuan per person; while the cost was (936.73 ± 5284.90) yuan in management group, which was lower than it in control group as (1181.50 ± 7937.90) yuan. The average annual direct medical expense in hypertension was (2275.08 ± 8225.66) yuan per person; while the expense was (2165.10 ± 6564.60) yuan in management group and (2375.20 ± 9487.60) yuan in control group. The average annual direct medical expense in urban ((2801.06 ± 9428.54) yuan per person) was higher than it in rural ((1254.70 ± 4990.27) yuan per person).

CONCLUSIONThe community health or standardized management of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.

Aged ; Community Health Services ; economics ; Cost-Benefit Analysis ; Drug Costs ; Female ; Health Care Costs ; statistics & numerical data ; Humans ; Hypertension ; drug therapy ; economics ; Male ; Middle Aged ; Public Health ; economics

No abstract available.
Delivery of Health Care* ; Health Care Costs* ; Poverty*

PURPOSE: Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs. METHODS: In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed. RESULTS: The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists > or = 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs. CONCLUSION: Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery.
Delivery of Health Care ; Health Care Costs ; Hospital Costs ; Hospital Mortality ; Humans ; Length of Stay ; Mortality ; Multivariate Analysis ; Pancreatectomy ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Postoperative Complications* ; Risk Factors