Journal of Digital Policy (디지털정책학회지)

The Society of Digital Policy and Management (한국디지털정책학회)
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Nursing Hospital Medical Expenses and Medical Service Policy

요양병원 의료비 및 의료서비스 정책

  • Kim, Ho-Yeong (Dept. of Business Administration, Pusan National University) ;
  • Kim, Dong-Il (Dept. of Business Administration, Pusan National University)
  • Received : 2022.08.23
  • Accepted : 2022.09.20
  • Published : 2022.09.28
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Abstract

This Study will focus the fact that large portion of inpatient treatment cost might incurred in nursing hospital and consider whether policy of allowing inpatient treatment is appropriate or not. Finally This study will suggest alternative way to make improvement based on cases from other countries. This study use data published by Health Insurance Review & Assessment Service. & National Health Insurance Service which is very reliable. This Study found biggest medical spending in allowance of medical care is inpatient treatment cost and large portion of inpatient treatment cost might incurred in nursing hospital. This Study found policy of allowing patient to get inpatient treatment is not clearly determinded. Therefore patient who don't actullay need medical service enter and stay in nursing hospital. Their inpatient treatment cost is paid by allowance of medical care and this cost is unnescessary medical cost. This study suggest policy of allowing patient need to be clear. Government should mandate nursing hospital to check whether patient's condition is appropriate to enter and stay in nursing hospital. This study suggest way to reduce unnecessary inpatient treatment cost incurred in nursing hospital

본 연구에서는 요양병원이 입원비 지출 발생에 기여도가 큰점을 주목하여, 요양병원의 입원정책을 살펴보고, 불필요한 입원비발생을 유발한 점이 있다면, 해외사례를 참조하여 개선방안을 제안하고자 한다. 본 연구는 건강보험공단과 건강보험심사평가원에서 발행한 건강보험통계연보, 건강보험 주요통계를 주로 활용하여 연구를 진행하였다. 이를 바탕으로 요양병원이 입원비 발생에 가장 큰 기여를 한다는 것을 추론하였다. 본 연구 결과 요양병원의 입원규정이 명문화 되지 않았다는 문제점을 발견하였고, 명문화 되지않은 입원 기준이 불필요한 입원비 발생해 기여 할수 있다는 점을 발견하였고, 이를 극복하기 위한 개선방안을 우리보다 먼저 고령화를 경험한 미국의 사례에서 제안해보았다. 본연구를 시작으로 요양병원에서의 불필요한 입원비 지출을 줄인 보다 많은 외국의 사례들을 찾아야 할 것이다.

Keywords

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