• 보건행정학회지
• /
• 제2권1호
• /
• pp.1-16
• /
• 1992

This study compares the physician payment of national fee schedule for Korean Medical Insurance with that of the United States based on Resource Based Relative Value Scales (RBRVS) which Hsiao developed in 1988 for the Medicare reimbursement. Through the comparison of two fees schedules, this study is purposed to evaluate the appropriateness of relative values which assigned to each physician services of Korean fee schedule. A total of 264 physician services are selected for the comparison. The ratio of Korean schedule to RBRVS is selected as an index of appropriateness. It the score of index shows large variation among services, the relative value of Korean fee schedule is inappropriate with U.S. RBRVS which was developed recently. The Ratios of Korean schedule to RBRVS are widly variated ; the range of those is 8.1 to 379.3. In subgroups which are regrouped to controll systematic differences between two national fee schedules, these ratios are also variated. Services which are relatively less compensated are management/evaluation services, while services which are relatively more compensated are invasive and imaging services. By the way, the service classification of Korean fee schedule is unclear, specially in management/evalutaion services. Therefore, Korean Medical Insurance fee schedule should be modified to be more balanced and rational.

• Journal of Forest and Environmental Science
• /
• 제32권1호
• /
• pp.55-67
• /
• 2016

This paper investigated policies that drive the sustainable management of Ivorian forest which disappear at an annual rate of 250000 hectares. Based on an inter-temporal model for optimum allocation of forest land to three competing uses, the article found that sustainability depends on the incentive structure, of which forest taxes and fees are a key, though obviously not the sole, component. The study proposed to increase the area fee level by accounting for environmental externalities generated by forest harvesters and farmers. The paper showed that the area fee is a decreasing function of the forest natural rate of regeneration and the reconversion rate of agricultural surfaces. Finally, at the given forest natural rate of regeneration and the reconversion rate of agricultural surfaces, the model argued that the area fee need to be progressive (arithmetic progression) in the context of ecological equilibrium break while it should remain constant in normal situation.

• 보건행정학회지
• /
• 제8권2호
• /
• pp.76-87
• /
• 1998

This study analyzed the effect of foreign currency exchange rate on the increasing rate of medical care cost by items of fee schedule of Korean Medical Insurance. This study uses the data of cost analysis including cost of imported goods and the data of for a university hospital National Federation's Medical Insurance for a trend of claim. The method of cost analysis is as same as that used in the study of the development of Korean RBRVS(Resource Based Relative Valus Scale). The main findings of this study are as follows; 1. The proportion of imported goods in cost related to Medical Insurance fee schedule is 7.93%, and in case of substitution of available domestic goods 6.96%. 2. If foreign currency exchange rate changes from 800wen per $1 to 1,300won, the affecting rate of Medical Insurance fee schedules is 5.00%. If the imported goods will be substituted with available domestic goods, the rate 4.35%. Our results can be used a data for updating Medical Insurance fee schedule. But this result is limited to be generalized, because this study used the cost analysis for a university hospital.

• 경영정보학연구
• /
• 제6권1호
• /
• pp.37-51
• /
• 2004

2001년부터 시행된 유료화 정책으로 콘텐츠 제공 업체의 수익분포에서는 콘텐츠 판매액이 광고를 제치고 제 1의 수익원으로 떠오른 반면, 커뮤니티를 모델로 하는 인터넷 기업들은 다양한 수익모델의 창출에 어려움을 겪고 있다. 이의 타개책으로 대표적인 커뮤니티 사이트인 프리챌이 차별화된 서비스를 기반으로 2002년 11월 유료화를 시도하였으나 기존회원의 탈퇴와 신규 회원 확보의 실패로 2003년 6월 다시 무료화로 전환하였다. 광고수입에 의존하고 있던 많은 인터넷 기업들이 경쟁회피와 수익창출을 위해 유료화 전환을 시도하고 있으나 관련 분야의 연구가 거의 없어 정책 수립에 어려움을 겪고 있다. 본 연구에서는 커뮤니티 사이트의 특성 및 수익구조와 프리챌의 유료화 과정을 체계적으로 살펴봄으로써 커뮤니티 사이트의 유료화 정책 및 운영에 대한 시사점을 도출한다.

• 보건행정학회지
• /
• 제23권4호
• /
• pp.343-348
• /
• 2013

Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta's fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.

• Industrial Engineering and Management Systems
• /
• 제4권2호
• /
• pp.218-227
• /
• 2005

In this research a model for establishing a new, rational fee schedule for general surgical procedures in a national health insurance program is developed. A fuzzy multiple criteria decision-making (FMCDM) model is proposed. The relative values of eleven surgical procedures were obtained through an empirical study based on the FMCDM model. Consequently, a new fee schedule obtained from the FMCDM model. This new fee schedule is more convincing than previous schedule and more persuasive to the references for the policy setting.

• 한국산림과학회지
• /
• 제96권5호
• /
• pp.543-550
• /
• 2007

Arguments against charging fees for use of recreational forests and parks generally rest on the assumption that the public sector has the responsibility to provide as many recreational opportunities as it can to all visitors in Korea. The entrance fee in recreational forests allowed some governmental resource management agencies to keep a portion of user fees generated on-site, instead of returning all revenue to the general treasury. Funded primarily through entrance, activity, parking, and mountain villa-use fees, this legislation has been successful in reducing the maintenance backlog for participating agencies. However, it is unclear what effect user fees might have on visitors attending interpretive programs and the benefits that agencies might receive from implementing this policy. From this point of view, this study is a similar case at the Visitor Center and Species Restoration Center at Jirisan in terms of fee-based field trips to the places. In this research, two hundred twenty-three visitors at the Visitor Center and Species Restoration Center at Jirisan National Park answered questions about their trips from 2005 to 2006. Results indicted that the ecoguide not only increased visitor's appreciation of the resource, but also enhanced their perceptions of the Korean National Park Service (KNPS) fee policies.

• 보건행정학회지
• /
• 제11권3호
• /
• pp.71-88
• /
• 2001

The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991ｇ/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834ｇ/$cm^2$, respectively.

• 보건행정학회지
• /
• 제5권2호
• /
• pp.202-229
• /
• 1995

In Korea, Resource-Based Relative Value Scale(RBRVS) is suggesting to the alternative of Korean Medical Fee Schedule. This study developed to methodology of RBRVS applicable to Korean situation and applied to services of internal medicine and general surgery. Our methodology of RBRVS is basically same to Hsiao's. But there are some differences between our method and H냐매's because Korean medical situation differs to American. The first difference is method of measurement of work. The Unit of work in our study is total work including intra-servic work and pre-/post-service work. Secondly, in extrapolation, we use primary data gathered to small group of physician. Tertially, in measurement of practice cost, we directly survey to budget data of hosptials and analyse practice costs by service. Some results are presented in a companion article.

• 보건행정학회지
• /
• 제7권2호
• /
• pp.65-88
• /
• 1997

In Korea, telemedicine is still under the beginning stage, but we expect that the developing 'Information Highway' will make this technology more common place and more easily used in coming soon. Currently, three hospitals are providing telemedicine services with their subsidiary hospitals which are far away from their remote place. However, the fee schedule of telemedicine services are not well-settled down, of course not reimbursed through current health insurance system. This study aims to develop new payment system for medical services provided through telemedicaine system. To design appropriate fee schedule for telemedicine services, we, first, review the current insurance payment system and telemedicine system both in domestic and foreign countries focusing on its payment system. A framework of telemedicine payment system is proposed in following steps based on information we acquired from this stage. Second. We decide the span of cost items which should be covered by telemedicine payment scheme. In hear, we suggest payment method for telemedicine services should be designed as dual structure which are telemedicine fee that should be reimbursed through payment scheme and any costs related to capital investment that should not be covered by payment system. Which is, payment system for telemedicine services should cover only service-related costs and any costs related to capital investment should be generated through third party such as government, health insurance association, etc. Finally, we suggest new fee schedules for telemedicine services. The key issues on developing telemedicine fee schedules are related with the determination of appropriate additional rate($\alpha$). The reasonable additional rate($\alpha$) must determine through careful evaluation of any additional efforts(e. g. : additional work hours which are related to providing telemedicine services). This study shows the process of how to determine appropriate additional rate($\alpha$).