• Title/Summary/Keyword: 진료비

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Type of medical institutions according to the Equipment List and inspection fee computed tomogaphy relationship between (의료기관 종별에 따른 전산화단층촬영장비 보유현황과 검사료간의 관계)

  • Kim, Min-Cheol;Lim, Cheong-Hwan
    • Proceedings of the Korea Contents Association Conference
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    • 2011.05a
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    • pp.195-196
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    • 2011
  • 1996년 이후부터 전산화단층촬영 검사가 건강보험급여대상이 되면서 이용률과 보급률이 더욱 증가되고 있으며 검사범위의 확대, 검사시간의 단축, 반복검사의 용이성, 이용의 편리성, 결과의 신뢰성, 장치의 구조적인 요소 및 검사 시행 횟수의 증가 등으로 검사량이 증가되고 있는 실정이다. CT 검사 건수의 증가요인으로 새로운 CT장비의 개발과 더불어 급격한 장비도입 증가 추세가 있으므로 이에 본 연구에서는 의료기관 종별 및 시기별 CT 장치 보유현황과 검사료간의 관계를 파악하였다. CT 장비는 병원급은 증가하고 있는 추세이나 의원급은 감소하고 있는 것으로 나타났다. CT진료비 청구는 80%이상이 종합전문요양기관과 종합병원에서 청구하는 것으로 나타났다. 이에 본 연구에서는 고가의료영상 진단 장비인 CT의 세대별 발달장비 도입 시기에 따른 우리나라 CT의 현황을 조사 분석하여 제시하여 고가의료장비 수급의 정책수립의 계기 및 기여하고자 한다.

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Hospital's Internal Review Procedure of Health Insurance Reimbursement (병원의 진료비 청구 자체심사 과정과 이의신청 사례)

  • Choi, Gil-Lim;Kim, Won-Joong
    • Korea Journal of Hospital Management
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    • v.7 no.3
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    • pp.121-136
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    • 2002
  • The main purpose of this study is to examine the overall procedure of hospital's internal review of health insurance reimbursement, to present the case of protest against reimbursement cut, and hence to provide some information on hospital's management of medical revenue. The object of the case study is 'P' university medical center, possessing 5 different hospitals under its system. Presentation of the case of protest against reimbursement cut has following meanings: Firstly, to the hospitals that already have internal review departments, information on the details of the protest process and results can be exchanged. Secondly, to the Government and National Health Insurance Corporation, useful data are provided for the improvement of the rules and procedures of health insurance reimbursement. Thirdly, to the hospitals without internal review departments, fundamental materials on the internal review process are provided for the effective management of medical revenue.

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Development of a Medial Care Cost Prediction Model for Cancer Patients Using Case-Based Reasoning (사례기반 추론을 이용한 암 환자 진료비 예측 모형의 개발)

  • Chung, Suk-Hoon;Suh, Yong-Moo
    • Asia pacific journal of information systems
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    • v.16 no.2
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    • pp.69-84
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    • 2006
  • Importance of Today's diffusion of integrated hospital information systems is that various and huge amount of data is being accumulated in their database systems. Many researchers have studied utilizing such hospital data. While most researches were conducted mainly for medical diagnosis, there have been insufficient studies to develop medical care cost prediction model, especially using machine learning techniques. In this research, therefore, we built a medical care cost prediction model for cancer patients using CBR (Case-Based Reasoning), one of the machine learning techniques. Its performance was compared with those of Neural Networks and Decision Tree models. As a result of the experiment, the CBR prediction model was shown to be the best in general with respect to error rate and linearity between real values and predicted values. It is believed that the medical care cost prediction model can be utilized for the effective management of limited resources in hospitals.

Characteristics of Daily Average Medical Charge of the Inpatients of an Oriental Medical University Hospital (한방병원 입원한자의 진료과별 및 재원일별 평균진료비의 분포적 특성)

  • Kang Tak-Lim
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.1
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    • pp.91-103
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    • 2000
  • This study was performed to find out characteristics of daily average medical charge of the inpatients of an oriental medical university hospital in TaeJeon. The sample of the study was 966 inpatients discharged from the 4 clinical departments of th hospital from January 1 to June 31, 1998. The major findings are as follows : 1. The average length of stay was 15.6 days in dept. of Internal Medicine, 16.9 in Acupuncture, 10.1 in Neuro-psychiatry and 24.3 in Physical therapy Daily average medical charge of the depart ments was 70,517 Won 62,011 Won, 82,750Won and 65,390 Won respectively. 2. The daily average medical charge of the departments was highest in the first day of admission. From the second day, it maintained a lower and relatively constant level, but showing slight fluctation in the latter halt of the hospital stay.

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Is the Hospital Caseload of Diagnosis Related Groups Related to Medical Charges and Length of Stay? (DRGs(Diagnosis Related Groups)별 환자집중도 수준에 따른 입원진료비와 재원일수의 차이 분석)

  • Kwak, Jin-Mi;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.13-24
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    • 2014
  • This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

Analysis of Utilization and Expenses of Medical Care Services in a Designated Rural Areas (일부 농촌지역주민의 의료이용량 및 진료비분석)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.125-133
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    • 1991
  • The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.

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National hospital discharge survey for the hospitals with fewer than 100 beds: A pilot project and evaluation (100병상미만 의료기관대상 퇴원환자조사 시범운영 및 평가)

  • Kim, Kwang-Hwan
    • Proceedings of the KAIS Fall Conference
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    • 2010.05b
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    • pp.579-581
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    • 2010
  • 2007년1월1일부터 12월 31일까지 퇴원환자조사에서 제외되었던, 100병상미만 의료기관을 조사대상으로 선정하였다. 퇴원환자조사를 위해 조사 기반자료인 의무기록을 토대로 손상퇴원환자의 일반적 특성, 진료비지불방법, 질병 및 수술 양상과 의료이용 실태를 파악하였다. 2007년 한 해동안 전국 100병상미만의 급성기 의료기관을 퇴원한 추정 환자수는 총 4,697,095명으로 이는 전체 인구의 9.7%에 해당 한다. 인구 10만명당 퇴원율은 9,693명이며 평균재원일수는 9.8일이었다. 퇴원후 귀가한 퇴원환자수는 전체 4,538,861명이었고 이중 남성은 1,784,041명, 여성은 2,754,821명이었다. 타병원으로 이송된 환자는 119,378명이었으며 의뢰병원으로 회송된 환자도 8,970명 이었다.

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구강건강관리

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.26 no.6 s.283
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    • pp.6-13
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    • 2002
  • 최근 우리나라 의료보험재정에서 구강진료비로 사용된 액수가 1990년에 1,869억원이었고, 1994년에 2,786억원, 1995년도에 3,507억원, 1998에는 5,986억원, 1999년에는 6,778억원으로 지난 10년간 계속 증가하는 양상을 보이고 있다. 그러나 치아우식증과 치주병으로 인하여 발거된 치아를 보철하는 비용은 이 치료비보다 훨씬 많을 것으로 추정되고 있어서 구강건강 관리비가 국민에게 부담이 되고 있을 것으로 추정된다. 과거부터 치아건강이 오복의 하나에 들 만큼 소중함에도 불구하고 여전히 치아우식증(충치)를 포함한 구강질환은 우리나라 사람의 다빈도 질환으로 자리 잡고 있다. 이달의 건강 길라잡이에서는 6월 9일 ‘치아의 날’에 즈음하여 일반적인 구강건강과 특히 청소년기 치아건강의 중요성을 새롭게 인식함으로써 외상으로부터 치아를 보호하여 평생 치아건강으로 적극적인 건강생활을 실천하는 계기를 마련하고자 한다.

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Factors Affecting the Daily Charges in Patients with Lumbar Discectomy - A Comparison of linear regression versus Multilevel Modeling (요추 추간판제거술 환자의 일일진료비에 영향을 주는 요인 - 선형회귀와 다수준 선형회귀 모델의 비교)

  • Kim, Sang-Mi;Lee, Hae-Jong
    • Korea Journal of Hospital Management
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    • v.20 no.1
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    • pp.53-64
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    • 2015
  • Our objective was to evaluate differences in linear regression versus multilevel(cross-level interaction model) modeling for affecting factors lumbar discectomy. The data were used in 2011 patients with HIRA sample data. Total number of analysis is 3,641 patients and 248 hospitals. The results of research model showed that the type and location of the hospital-level factors were significant. However, all factors of patient-level were similar in the two models. Therefore, it requires the selection of an appropriate model for a more accurate analysis of the influencing factors in the daily medical charge.

Structural Characteristics and Feasibility of Per Diem Payment System for Elderly Dementia Inpatients (치매노인환자 입원진료비의 구조적 특성과 일당수가제화의 타당성)

  • Kim, Jae-Sun
    • Korea Journal of Hospital Management
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    • v.4 no.1
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    • pp.66-95
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    • 1999
  • This study was conducted to analyze the medical charges of the elderly dementia inpatients, to identity their characteristics, and there by to evaluate feasibility of the per diem payment system for the patients. Data on medical charges of the patients were collected from the National Federation of Medical Insurance and sample hospitals from October through December 1997. The data were analysed in order to find the characteristics and test hypotheses postulated. The results are summarized as follows; Firstly, there was no difference statistically in between disease groups and between the dementia inpatients belonging to each disease group. Secondly, the amount of the non-insurance medical charges of the elderly dementia inpatients is considerably high compared to the insurance medical charges paid by the patient, which implies that some measures are to be prepared by the Government. Finally, medical charges per inpatient day of the dementia patients are not different statiscally by sex, by age group, and by disease group. This result supports the feasibility of the per diem payment system for the elderly dementia inpatients.

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