• Title/Summary/Keyword: 요양병원 수가제도

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A Study on Medical Fee System of the convalescent hospital -Focused on the case of patient group adjustment - (요양병원 수가제도에 대한 소고 -환자군 조정 판결을 중심으로 -)

  • Kwon, Hye Ok
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.195-218
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    • 2017
  • The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

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Improvement of Management of Long-Term Care Facilities Through FGI (FGI를 통한 노인장기요양시설 운영 개선 방향에 관한 연구)

  • Park, Sung Won;Lee, Won Jae
    • The Journal of the Korea Contents Association
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    • v.19 no.1
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    • pp.587-597
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    • 2019
  • With the rapid aging of the nation's population and the increasing number of elderly people with difficulties in daily life, the elderly care system was implemented for social solidarity. Structural problems in the long-term care system that emerged after the introduction of the system are demanded, and the problem of functional readjustment between nursing hospitals and facilities is raised due to the lack of continuity of care for the elderly by institutional and salary types. In this study, we set up research problems related to personnel, staff, and services to address the problem and conducted FGI. Research has shown that the number of elderly and recognized people in the region, the number of elderly and elderly patients, needs to be reflected in long-term care demand, the direction of appropriate institutional and manpower supply policies, and the establishment of local government goals and plans to strengthen the long-care institutions. It was revealed that non-medical accident arbitration bodies are needed to apply the cost of food insurance, provide programs through links with relevant institutions, and manage the admission smoothly.

Occupational Therapy in Long-Term Care Insurance For the Elderly Using Text Mining (텍스트 마이닝을 활용한 노인장기요양보험에서의 작업치료: 2007-2018년)

  • Cho, Min Seok;Baek, Soon Hyung;Park, Eom-Ji;Park, Soo Hee
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.67-74
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    • 2018
  • Objective : The purpose of this study is to quantitatively analyze the role of occupational therapy in long - term care insurance for the elderly using text mining, one of the big data analysis techniques. Method : For the analysis of newspaper articles, "Long - Term Care Insurance for the Elderly + Occupational Therapy for the Elderly" was collected after the period from 2007 to 208. Naver, which has a high share of the domestic search engine, utilized the database of Naver News by utilizing Textom, a web crawling tool. After collecting the article title and original text of 510 news data from the collection of the elderly long term care insurance + occupational therapy search, we analyzed the article frequency and key words by year. Result : In terms of the frequency of articles published by year, the number of articles published in 2015 and 2017 was the highest with 70 articles (13.7%), and the top 10 terms of the key word analysis showed the highest frequency of 'dementia' (344) In terms of key words, dementia, treatment, hospital, health, service, rehabilitation, facilities, institution, grade, elderly, professional, salary, industrial complex and people are related. Conclusion : In this study, it is meaningful that the textual mining technique was used to more objectively confirm the social needs and the role of the occupational therapist for the dementia and rehabilitation in the related key keywords based on the media reporting trend of the elderly long - term care insurance for 11 years. Based on the results of this study, future research should expand research field and period and supplement the research methodology through various analysis methods according to the year.

Analysis of the Payment Rates and Classification of Services on Radiation Oncology (치료방사선과 의료서비스에 대한 원가산정)

  • Shin Kyung Hwan;Shin Hyun Soo;Pyo Hong Ryull;Lee Kyu Chan;Lee Yoon Tae;Myoung Hee Bong;Yeom Yong Kwon
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.167-174
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    • 1997
  • Purpose : The main Purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. Material and Methods : A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as Payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current Payment rates of individual services. Results : The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12-2.55 times lower in total body irradiation. Conclusion : We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.

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The Trend of Inpatients in California State Hospitals and Its Implications for Mental Health Policies in Korea (캘리포니아주 주립병원 입원환자들의 변화 추세 및 한국 정신보건제도의 발전을 위한 정책적 함의)

  • Hwang, Sung-Dong
    • Korean Journal of Social Welfare
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    • v.39
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    • pp.350-373
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    • 1999
  • The patient population of U. S. state mental hospitals has changed drastically since the 1960s, when the deintstitutionalization movement began. This paper is designed to look at what happened to the number of inpatients of state hospitals in California during the last 150 years and, from this, to explore implications for the future of the mental health system in Korea, especially for the viability of mental hospitals. The data had been collected by field research(visits to state hospitals and State Department of Mental Health, and interviews with mental health administrators) and accessing statistical publications and various reports. Since the first state hospital opened in 1851 the statewide inpatient population of individuals who were mentally disabled has grown and peaked at 37,489 in 1959. The number of patients in state hospitals, however, began declining in the early 1960s and was reduced to 10,874 by 1971, and to 4,973 by 1986. As of 1997, there were only 4, 263 inpatients remaining in the state hospital system. This dramatic decrease slowed down somewhat in 1980s and 1990s, but this trend seems irreversible except for the inpatients referred by the court. Now the beds in state hospitals are filled with more and more forensic patients, which constitutes nearly 70% of the total inpatient population. Based on these findings, it is well expected that the number of inpatients of mental hospitals in Korea will also be reduced in a significant way as the community-based mental health care system is gradually replacing the traditional one. Mental hospitals need to introduce more diversified programs for the care of the mentally ill, and concurrently more vigorous aftercare programs are required in the community.

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