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DRG 지불제도가 재원일수와 퇴원 후 외래방문일수에 미치는 영향: 2004-2007년도 제왕절개술을 중심으로

Impact of DRG Payment on the Length of Stay and the Number of Outpatient Visits After Discharge for Caesarean Section During 2004-2007

  • Shon, Chang-Woo (Seoul National University Graduate School of Public Health) ;
  • Chung, Seol-Hee (Health Insurance Review and Assessment Service) ;
  • Yi, Seon-Ju (Seoul National University Graduate School of Public Health) ;
  • Kwon, Soon-Man (Seoul National University Graduate School of Public Health)
  • 투고 : 2010.06.10
  • 심사 : 2010.11.08
  • 발행 : 2011.01.31

초록

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.

키워드

참고문헌

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피인용 문헌

  1. DRGs(Diagnosis Related Groups)별 환자집중도 수준에 따른 입원진료비와 재원일수의 차이 분석 vol.8, pp.4, 2011, https://doi.org/10.12811/kshsm.2014.8.4.013
  2. The effect of competition on the relationship between the introduction of the DRG system and quality of care in Korea vol.26, pp.1, 2011, https://doi.org/10.1093/eurpub/ckv162
  3. 포괄수가제도 당연적용 효과평가 vol.26, pp.2, 2011, https://doi.org/10.4332/kjhpa.2016.26.2.135
  4. Effects of a mandatory DRG payment system in South Korea: Analysis of multi-year nationwide hospital claims data vol.19, pp.1, 2019, https://doi.org/10.1186/s12913-019-4650-8