Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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A Study on Characteristics of Medical Expenses and the Hospitalization Period of Hospitalized Patients Using Diem Payment System at Convalescent Hospitals

요양병원 일당정액제 입원환자의 입원일수 및 진료비 특성에 관한 연구

  • Roh, Ock-Hee (Dept. of Hospital Management, Konyang Graduate School of Public Health & Welfare) ;
  • Lee, Chong Hyung (Dept. of Hospital Management, College of Medical Science, Konyang University) ;
  • Park, Arma (Dept. of General Art Education, Konyang University) ;
  • Kim, Kwang-Hwan (Dept. of Hospital Management, College of Medical Science, Konyang University)
  • 노옥희 (건양대학교 보건복지대학원 병원경영학과) ;
  • 이종형 (건양대학교 의과학대학 병원경영학과) ;
  • 박아르마 (건양대학교 기초교양교육대학) ;
  • 김광환 (건양대학교 의과학대학 병원경영학과)
  • Received : 2016.07.19
  • Accepted : 2016.08.11
  • Published : 2016.08.31
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Abstract

This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

본 연구의 목적은 일 지역 내 소재 요양병원에 입원하고 있는 일당정액제 환자의 입원일수 및 진료비 특성을 파악하고, 요양병원 입원일수 및 입원진료비 관련 현황을 분석하여, 향후 요양병원의 입원진료에 대한 적정성 방안을 찾기 위해 필요한 기초자료를 제공하는 것이다. 본 연구의 대상은 2014년 1월부터 12월까지 1년 간 대전, 충남, 충북, 세종 소재 요양병원 입원 환자가 건강보험심사평가원에 청구한 월별 청구자료 중 요양병원 1일당 정액수가제에 해당하는 44,037건이었다. 분석결과 연구대상자의 일반적 특성과 주 진단명 상위 15위 간의 정준상관분석 결과 7개의 정준함수가 도출되었으며, 그 중 6개의 정준함수가 통계적으로 유의한 것으로 나타났고(p<0.001), 정준함수 1에서는 카이제곱 값이 5955.49이고 자유도가 98일 때 p<0.001 수준에서 유의하게 나타났다. 본 연구에서는 지역사회 내 보건 복지서비스를 확대하면 사회적 입원을 줄일 수 있을 것으로 판단된다. 보건 복지서비스의 확대는 고령의 노인들에 대한 삶의 질을 향상시킬 수 있으며, 아울러 요양병원 입원일수를 단축시키고 총 진료비를 절감시켜 증가 일로에 있는 국민의료비의 지출 감소에도 기여할 것으로 판단된다.

Keywords

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