• 산업경영시스템학회지
• /
• 제35권2호
• /
• pp.181-188
• /
• 2012

The fee system on spectrum usage is a usage fee that is charged for using spectrum provided by a wireless tower, and is used for management and promotion of the waves. The current fee system for spectrum usage in South Korea has faced many problems, such as complex calculation for fees, unjustified charges, unfairness in cost sharing among providers, and general inefficiency of operation. This study focuses on comparison of fee systems for spectrum usage of South Korea and other foreign countries, extraction of the root causes and problems by case analyses, and recommendation for better solutions to make a reasonable fee system for spectrum usage. The result of this study can be used as a solution to render spectrum usage more effective.

• 한국병원경영학회지
• /
• 제4권2호
• /
• pp.21-40
• /
• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• 대한산업공학회지
• /
• 제34권2호
• /
• pp.216-222
• /
• 2008

The determination of spectrum charges for the operators is a main issue to efficiently manage the limited radio spectrum resources. In this paper, we propose a model to compute the optimal charges for radio spectrum usage. The objective is to determine that will maximize the spectrum charges, and decision variables of ratios for actual or estimated revenues are considered. The spectrum charges are maximized under satisfying the least profit for operators based on Log-Linear demand function. The parameters of actual sales and minimum profit of operators are analyzed to make an efficient management for radio spectrum. The results show that the spectrum charges increase as the actual sales increase, but it decrease as the required minimum profit of operator increases. It is also observed that the government should increase the ratio for estimated sales if anticipating the poor market in the future, otherwise they should increase the ratio for actual sales to maximize the spectrum charges.

• 보건행정학회지
• /
• 제29권1호
• /
• pp.40-48
• /
• 2019

Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

• 한국보건간호학회지
• /
• 제3권2호
• /
• pp.5-46
• /
• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• 한국문헌정보학회지
• /
• 제44권3호
• /
• pp.137-154
• /
• 2010

본 연구는 오픈액세스 출판을 위한 수입원들이 국내의 무료 오픈액세스 학술지와 유료 원문 학술지에서 어떻게 도입되고 있는지를 분석하고자 하였다. 그 결과 무료 오픈액세스 학술지와 유료 원문 학술지 간에 분명한 차이는 없었으며, 오히려 유료 원문서비스 학술지에서 오픈액세스 학술지 모델의 특성이 많이 나타나고 있음을 알 수 있었다. 즉, 논문처리비용을 저자측에 요구하고 있었으며, 연구비 수혜논문에 대한 추가 게재료를 부과하고, 외부기관으로부터 지원금을 받는 경우도 무료 오픈액세스 학술지보다 더 많았다. 이것은 국내의 유료 원문 학술지가 무료 오픈액세스로 전환될 가능성이 상당히 높다는 것을 의미한다.

• 한국인터넷방송통신학회논문지
• /
• 제15권2호
• /
• pp.229-238
• /
• 2015

본 연구는 SNS를 활용하여 창작뮤지컬 공연을 관람하는 고객들의 경우 중요도-성취도(IPA: Importance Performance Analysis) 분석을 활용하여 창작뮤지컬 인식에 대한 중요도 및 만족도를 알아보고 공연업체의 창작 뮤지컬 인식을 향상시킬 수 있는 방안을 모색하고자 하였다. 즉, 공연기획자들이 점진적으로 신경쓰고 개선해야할 선택속성은 제 II사분면에 위치하여 창작뮤지컬 관람객들이 선택속성에 대해 중요하게 생각하고 있는 반면 이 평가속성에 대한 성취도에서는 낮게 평가된 상태로 향후 시급히 개선해야 하는 속성은 창작뮤지컬의 관람비용(티켓가격), 창작뮤지컬의 내용구성(뮤지컬의 엔딩장면, 기억에 남는 대사가 많음), 창작뮤지컬의 관람비용(공연장의 부대시설 이용요금), 창작뮤지컬의 공연장(공연장의 주차시설)으로 이를 개선하기 위해 지속적인 노력을 해야 한다. 또한, SNS를 활용하지 않고 창작뮤지컬 공연을 선택하는 관람객들의 경우 창작뮤지컬 선택속성(창작뮤지컬의 관람비용), 창작뮤지컬의 무대구성(무대의 음향시설), 창작뮤지컬의 연출(뮤지컬에서 나온 전반적인 음악), 창작뮤지컬의 관람비용(공연장의 부대시설 이용요금), 창작뮤지컬의 공연장(공연장의 주차시설)이라는 선택항목을 개선하기 위해 지속적으로 노력해야 함을 알 수 있다.

• 한국병원경영학회지
• /
• 제4권2호
• /
• pp.41-59
• /
• 1999

Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

• 보건행정학회지
• /
• 제7권1호
• /
• pp.100-124
• /
• 1997

In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

• 임상간호연구
• /
• 제23권2호
• /
• pp.236-247
• /
• 2017

Purpose: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. Methods: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. Results: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. Conclusion: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.