1.The AHP of criteria analysis weighting for assessment on medical equipment suppliers.
Bin LI ; Li-jun WANG ; Hong-yan ZHANG
Chinese Journal of Medical Instrumentation 2006;30(1):53-59
In order to improve the management of the supplier chain, it is necessary to setup a assessment system on suppliers. The assessment includes lot's of criteria such as quality, cost, service and delivery capabilities. The different criteria should have different weighting. The AHP method is chosen here in the paper to analyse the weighting of individual criteria.
Equipment and Supplies
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economics
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standards
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Quality Assurance, Health Care
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methods
2.Korean National Health Insurance Value Incentive Program: Achievements and Future Directions.
Sun Min KIM ; Won Mo JANG ; Hyun Ah AHN ; Hyang Jeong PARK ; Hye Sook AHN
Journal of Preventive Medicine and Public Health 2012;45(3):148-155
Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.
Benchmarking
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Hospitals
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Humans
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*National Health Programs
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Quality Improvement/*economics
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Quality of Health Care/economics
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Reimbursement, Incentive/*organization & administration
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Republic of Korea
3.Lessons From Healthcare Providers' Attitudes Toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program?.
Jin Yong LEE ; Sang Il LEE ; Min Woo JO
Journal of Preventive Medicine and Public Health 2012;45(3):137-147
We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.
*Attitude of Health Personnel
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Humans
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Program Development
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Quality Improvement/*economics
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Quality of Health Care/economics
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Reimbursement, Incentive/*organization & administration
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Republic of Korea
4.Designing an Effective Pay-for-performance System in the Korean National Health Insurance.
Journal of Preventive Medicine and Public Health 2012;45(3):127-136
The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.
*National Health Programs
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Program Development
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Quality Improvement/*economics
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Quality of Health Care/economics
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Reimbursement, Incentive/*organization & administration/standards
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Republic of Korea
6.Is cost-effective healthcare compatible with publicly financed academic medical centres?
Whay Kuang CHIA ; Han Chong TOH
Annals of the Academy of Medicine, Singapore 2013;42(1):42-48
Probably more than any country, Singapore has made significant investment into the biomedical enterprise as a proportion of its economy and size. This focus recently witnessed a shift towards a greater emphasis on translational and clinical development. Key to the realisation of this strategy will be Academic Medical Centres (AMCs), as a principal tool to developing and applying useful products for the market and further improving health outcomes. Here, we explore the principal value proposition of the AMC to Singapore society and its healthcare system. We question if the values inherent within academic medicine--that of inquiry, innovation, pedagogy and clinical exceptionalism--can be compatible with the seemingly paradoxical mandate of providing cost-effective or rationed healthcare.
Academic Medical Centers
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economics
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organization & administration
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Cost-Benefit Analysis
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Financing, Government
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Health Care Costs
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Health Care Rationing
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Quality of Health Care
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Singapore
7.Hospital management in China in a time of change.
Likun PEI ; David LEGGE ; Pauline STANTON
Chinese Medical Journal 2002;115(11):1716-1726
8.Study on Hospital Care Services between Insured and Non-insured Patients for Selected Diagnoses in Korea.
Yonsei Medical Journal 1983;24(1):6-32
Rapidly expanding health insurance programs have accompanied the rapid economic development of Korea over the past five years. Now more than thirty percent of the total population is covered by the various health insurance plans. The objective of this study is to discover differences that may exist in medical care services in terms of quantity, length of stay, charges and quality of care in treating insured and non-insured patients. Five common diagnostic categories (name1y, appendectomy cholecystectomy, tonsillectomy, Cesarean section and respiratory tract infection) were examined. The results confirmed the major hypotheses of the study, although some of the results were in the expected direction but not statistically significant: total hospital charges and charges per day were higher among the non-insured; volume of services was greater among the insured; length of stay was longer among the insured; quality of care did not show statistically significant differences in treatment outcomes and complications.
Adult
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Diagnosis-Related Groups
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Female
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Health Services/standards*
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Hospitalization/economics*
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Human
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Insurance, Health*
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Insurance, Health, Reimbursement
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Korea
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Length of Stay
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Male
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Middle Age
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Quality of Health Care
9.Drug Utilization Review.
Journal of the Korean Medical Association 2004;47(2):156-162
Drug utilization review (DUR) is one of the approaches to improve quality of health care and reduce its costs. DUR programs have been defined as "structured, ongoing initiatives that interpret patterns of drug use in relation to predetermined criteria, attempting to prevent or to minimize inappropriate prescribing while maximizing the effectiveness of drug therapy to save costs." There have been a limited number of papers to evaluate the economic consequences of DUR programs, and they provide no definite evidence regarding the cost saving or costeffectiveness of the programs. A possible explanation for this would be that DUR might not be awarded a high priority, resulting in reduced opportunities for financing to DUR including development of a good program and its evaluation study. However, despite these problems, in Korea simple descriptive studies of drug utilization and the development of effective intervention strategies must start and continue in order to optimize drug therapy and to save costs in health care. Pharmacoeconomic studies are employed to measure drug efficiencies, through comparison of the costs and effects of alternative therapies. Theses studies can uncover the economics repercussions of inappropriate prescribing and quantify the cost effectiveness of various DUR interventions. The use of DUR in conjunction with pharmacoeconomic analysis will result in more costeffective and rational utilization of medicines. Both methods could be used in a complementary fashion. In conclusion, DUR processes will lead to the better utilization of drugs, based on improved economic and social performance.
Awards and Prizes
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Complementary Therapies
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Cost Savings
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Cost-Benefit Analysis
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Delivery of Health Care
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Drug Therapy
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Drug Utilization Review*
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Drug Utilization*
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Economics, Pharmaceutical
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Inappropriate Prescribing
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Korea
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Quality of Health Care
10.Health Economics and Outcomes Research.
Korean Journal of Family Medicine 2009;30(8):577-587
Health conomics refers to the scientific discipline that compares the value of one healthcare program to another. It is a sub-discipline of Micro-economics. A health economic study evaluates the cost (expressed in monetary terms) and effects (expressed in terms of monetary value, efficacy or enhanced quality of life) of a healthcare program or product. We can distinguish several types of health economic evaluation: cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis and cost-utility analysis. Health economics studies serve to guide optimal healthcare resource allocation, in a standardized and scientifically grounded manner. Health economics research facilitates the translation of health technology assessment into useful information for healthcare decision-makers to ensure that society allocates scarce health care resources wisely, fairly and efficiently. Health economics usually evaluate the outcomes like clinical, economics and humanistic outcomes per costs. Health economics research include pharmacoeconomics, clinical epidemiology, decision analysis, modeling, risk assessment, patient-reported outcomes (quality of life), database analyses, observational studies, and patients registries.
Biomedical Technology
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Cost-Benefit Analysis
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Decision Support Techniques
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Delivery of Health Care
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Dietary Sucrose
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Economics, Pharmaceutical
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Humans
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Outcome Assessment (Health Care)
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Quality of Life
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Registries
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Resource Allocation
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Risk Assessment