• 제목/요약/키워드: Fee-for-service

검색결과 384건 처리시간 0.022초

요양병원형수가제 전환에 대한 요양병원의 평가 및 개선방안 연구 (A Study on Evaluation and Improvement of Long-term Care Hospitals for Changing Long-term Care Hospital Fee System)

  • 김영배
    • 보건의료산업학회지
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    • 제5권2호
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    • pp.105-117
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    • 2011
  • The purpose of this study is to investigate evaluation and improvement of long-term care hospitals for changing long-term care hospitals fee system. Data were collected from 104 CEOs in nationwide long-term care hospitals using structured self-administered questionnaires during August 17 to 31, 2009. Major results of the empirical analysis are as follows; first, to change fixed sum medical fee per day caused to decline the level of geriatric service in 87% of CEOs. Second, 79% of CEOs were dissatisfied with changing fixed sum medical fee per day, and 47% of them were dissatisfied with graded fee for doctor and nurse management. Finally, they suggested that to specialize and to differentiate of long-term care hospitals will drive to improve long-term care hospitals function and to measure workforce based on rate of filled vacancies will increase efficiency and productivity of doctor and nurse management.

서비스 가치 관점에서의 e-정보서비스 사용 의도에 관한 연구 (Determinants of the intention to use information services)

  • 한정희;장활식
    • 한국정보시스템학회지:정보시스템연구
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    • 제13권1호
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    • pp.97-119
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    • 2004
  • Recently, many e-business companies started to charge fees to the use of information contents service. However, little is known about how users evaluate and determine to purchase information services. Past technology adoption research has focused primarily on the positive utility gains side, focusing on usefulness and ease of use. Purchase of e-service, however, involves not only the position utilities but also negative utilities. This research uses the service value model(SVM) and explains user's intention of purchasing a new information service. Based on the Perceived Value Framework, this research investigates the impacts of the service quality and the fee charge on the user's perceived service value and further on user's intention of adopting the e-service. One of the most important postulations of this research is that both service quality and the fee charge influence user's intention through affecting the user's perceived service value. This research presences a conceptual model of users' e-service evaluation process. The conceptual framework provides a basis for understanding how perceptions of quality and sacrifice influence value perceptions and purchase intentions. The results of an empirical research suggest that the both service quality and fee charge have influences on the perceived service value. However, they do not directly affect user's intention to purchase the e-service. They affect user's intention to purchase through affecting the perceived service value. In conclusion, this research provides a base to build on for other research studying use intention model of new e-service.

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시스템사고로 본 정부의 규제정책 - 의료수가 규제를 중심으로 - (A Study on the Government Regulation with Systems Thinking - Focus on tile Medical Fee Regulation -)

  • 김도훈;홍영교
    • 한국시스템다이내믹스연구
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    • 제6권2호
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    • pp.53-71
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    • 2005
  • In the short view, the medical fee regulation has contributed for patients by reducing their hospital expenses and helping them to visit hospital more easily. But, some medical parts have gone into red ink because the medical fee has been different with each item. So, that medical parts have been experienced the medical specialist shortage. And some hospitals have been interested in high-priced medical services to cover their deficit. Moreover, most medical doctors don't need to use low-priced medicine undergo these circumstance, domestic small and medium pharmaceutical company has been going into bankruptcy and the dependence on foreign drug company has been rising. If these abnormal medical service keep to patience, people will get more burden of medical fee cause 9 casual loop work very complicated. In other words, present medical fee regulation were made by some politicians who had plain thinking. Those who govern the people, therefore, stand for not present medical service user but the welfare and health promotion of people and give attention to desirable medical fee with systems thinking.

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적정 작업환경측정수수료 산정을 위한 소고 (Essay on the Calculation of Appropriate Working Environment Measurement Fees)

  • 박지연
    • 한국산업보건학회지
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    • 제31권3호
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    • pp.274-285
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    • 2021
  • Objectives: The question of whether the level of fees paid to working environment measurement agencies is appropriate has long been a matter of concern to the government. In addition, measurement institutions express dissatisfaction with their level of compensation, which has a great influence on the evaluation of a subject's policy. This study is intended to find a way to appropriately calculate working environment measurement fees. Methods: We looked at the principle of fee determination as a basic theory of fee calculation used in fee calculation, the legal and academic aspects of the general method of fee calculation, and government cost calculation standards. Furthermore, we reviewed the research methods applied so far to derive a method of calculating fees appropriate for this environment. Results: The working environment measurement environment is different from other commission calculation environments. The other environment is to appropriately calculate the service price provided by a monopoly public enterprise, while the situation is to appropriately calculate the fees provided by competitive private enterprises. Therefore, the service delivery environment and the delivery entity are different. In this case, the appropriate method of calculating service fees would be competitive pricing. There have also been many problems under the method of calculation by service cost. Conclusions: First, the working environment measurement fee requires an accounting correction of endogenous variables. Second, the theory of calculating fees appropriate for this situation is appropriate for competitive pricing that applies to private competitors. Third, the government should make efforts to make the service supply market a fully competitive market while ensuring that the service fee level is determined at the marginal cost level. Fourth, economically, research on marginal cost levels is needed.

사례분석을 통한 건설사업관리 대가산정 방법 개선 (Improvement of estimating method for construction management service fee by case study)

  • 이웅균;유위성;김동인;김태훈;차민수;조훈희
    • 한국건설관리학회논문집
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    • 제13권4호
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    • pp.16-24
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    • 2012
  • 본 연구는 국내 외 건설사업관리 유사 건설기술용역 대가 기준 및 사례분석을 토대로 합리적인 건설사업관리 대가기준을 제안하는 것을 목적으로 한다. 이를 위해 기존의 건설사업관리 대가의 적정성을 분석하고, 사례분석을 통한 인력투입 실태를 조사하였으며, 비상주 인력의 적정수준에 대해 고찰하였다. 사례분석결과, 현행 건설사업관리 대가산정 체계는 책임감리와의 대가산정 방식의 이원화, 비 현실적인 대가기준 및 인력배치 등이 문제점으로 도출되었다. 이를 위한 개선 방안으로 건설용역 대가산정 방식의 정비, 건설사업관리 대가수준의 현실화, 사업초기단계 배치인력의 탄력성 확보, 사업특성을 고려한 비상주 인력 활용을 제안하였다. 본 연구는 향후 건설사업관리의 대가수준의 현실화 및 대가산정을 위한 접근방법의 개선에 기여하여 건설사업관리 업무의 효율성 향상에 도움이 될 것으로 기대된다.

권역외상센터의 질 관리와 수가 개선 현황 (A Review of Quality Management and Improvement of Trauma Fee Schedule in Regional Trauma Center)

  • 서은원;임지혜
    • 보건행정학회지
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    • 제31권4호
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    • pp.399-408
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    • 2021
  • The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.

Does cost matter: How customer adopts the fee-based online content services?

  • Choi Jeon-Gil;Hong Soon-Goo;Kim In-Jai;Lee Sang-Guen
    • 한국정보시스템학회지:정보시스템연구
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    • 제13권1호
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    • pp.121-134
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    • 2004
  • As Internet usage widely grows, online content services such as newspaper, magazine, music, game and movie are provided with a fee-based subscription. Many content services providers consider charging a usage fee into its service provisions as one of the Internet business models for increasing revenue. There are customer resistances to adopting the fee-based service provision on the Web. Previous research in information systems (IS)has focused on the analysis of adoption of information technology or systems in the individual ororganization level. No principle research has been carried out on the user adoption behavior of online content services provisions. As users actively access content services on the Web, it needs to explore user adoption behavior in different settings. Many IS researcher have employedquantitative approaches, even though they deal with the process of user behavior regarding the information technology or system. In this study, we attempt to discover how customers adopt the fee-based provision of online content services by employing grounded theory, one of the principal qualitative research methods.

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활동기준 원가분석을 통한 건강보험수가의 적정성 분석 (An Analysis on Appropriateness of Health Insurance Fee Using the Activity Based Costing(ABC) Approach)

  • 김한성;신현웅;차재영
    • 한국병원경영학회지
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    • 제20권3호
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    • pp.36-44
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    • 2015
  • The Activity Based Costing(ABC) means the process that makes clear how the actions and input resources have changed into service to calculate medical services costs. These days, the number of hospital which is using the ABC system is increasing to make their policy decision making efficient and run the hospitals more resonable. This study analyzes the unbalance in the level of health insurance service fee and the improvement plans based from 8 hospitals(ABC system) and 95 clinics(ABC survey). The cost recovery ratio has shown different levels according to each service type. A surgery service type recorded 76.8% and an evaluation & management service type is 84.6%, a treatment procedure type(85.8%), a function test type(91.6%) and health insurance fee even did not reach to the original cost. Meanwhile, a laboratory test type and imaging test type show high level of cost recovery ratio. they recorded 188.3% and 158.8%. Resultingly now of unbalance in the level of health insurance service fee accelerates supply of every test. so there is a need to make laboratory test type and imaging test type lower to keep balance with the surgery and medical service. These methods should be performed gradually with monitoring the unbalance fee ratio and for this, a panel medical institution have to be established for generalizations of studying result, fairness of selecting researching sample.

서비스양을 고려한 수가 결정모형에 의한 추정 환산지수와 실제 환산지수의 비교 (Comparison Actual Conversion Factor with Estimated Conversion Factor by Fee Adjustment Model Reflecting Health Service Volume)

  • 한기명;조민호;이수진;전기홍
    • 보건행정학회지
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    • 제23권4호
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    • pp.343-348
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    • 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.

적정간호수가 산정모형 개발을 위한 연구 (Development of a Nursing Fee Schedule Model)

  • 조소영;박정호
    • 대한간호학회지
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    • 제23권1호
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    • pp.68-89
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    • 1993
  • This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6% of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6%) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

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