• Title/Summary/Keyword: Fee-for-service plans

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

  • Kim, Han-Sung;Shin, Hyun-Woung;Cha, Jae-Young
    • Korea Journal of Hospital Management
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    • v.20 no.3
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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.

A Study on the Plan for Rationalizing Warehouse Storage Fee of LCL Cargo imported by Sea (해상수입 LCL화물의 창고보관료 적정화방안에 관한 연구)

  • Kim, Yong-Jin;Seo, Dong-Gyun
    • Journal of Korea Port Economic Association
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    • v.26 no.4
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    • pp.310-328
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    • 2010
  • The purpose of this study is to contribute to reducing distribution costs, enhancing export price competitiveness, and improving distribution system in LCL cargo, by pursuing the present status of warehouse storage fee, a cause & problem about excessive hike, and a plan for stabilizing warehouse storage fee, as for LCL Cargo, which is imported by sea. The plans for rationalizing warehouse storage fee in LCL cargo were suggested the adoption of the ceiling system for warehouse storage fee rate, the obligation of offering information on warehouse storage fee rate, the eradication of illegal rebate, the improvement in distribution system of the imported LCL cargo, a scheme for the importer to designate a bonded warehouse and forwarder, the introduction of the tentatively named 'LORAS(Lowest Rate Service),' and formation of the dispute coordinating committee for warehouse storage fee.

The Calculation of Geographic Practice Cost Index and the Feasibility of Using It in Korean Payment System (진료비용 지역보정지수의 산출 및 국내 적용의 타당성)

  • Kim, Hansang;Chung, Seol Hee
    • Health Policy and Management
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    • v.29 no.2
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    • pp.130-137
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    • 2019
  • The fee-for-service system is used as the main payment system for health care providers in Korea. It has been argued that it can't reflect differences in the medical practice costs across regions because the fee schedule is calculated based on the average cost. So, some researchers and providers have disputed that there is need for adopting geographic practice cost index (GPCI) used in the United States for the Medicare program for the elderly to the fee-for-service payment system. This study performed to identify whether the difference in the practice costs among regions exists or not and to examine the feasibility of applying GPCI to Korea payment system. For this purpose, we calculated modified-GPCI and examined considerations to introduce GPCI in Korea. First we identified available data to calculate GPCI. Second, we made applicable GPCI equations to Korea payment system and computed it based on four types of regions (metropolitan, urban, suburban, and rural). We also categorize the regions based on the availability of the medical resources and the capability of utilizing them. As a result, we found that there wasn't any significant difference in the GPCI by regional types in general, but the indices of rural areas (0.91-0.98) was relatively low compared to the indices of other regions (0.96-1.07). Considering the need to use GPCI floor, the pros and cons of using GPCI, and the concern of the regional imbalance of resources, the introduction of GPCI needs to be carefully considered.

Changes in the Medical Cost and Practice Pattern according to the Implementation of per Diem Payment in Hospice Palliative Care (완화의료 일당정액수가제 시행에 따른 진료비와 진료행태의 변화)

  • Lim, Mun Nam;Choi, Seong Woo;Ryu, So Yeon;Han, Mi Ah
    • Health Policy and Management
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    • v.29 no.1
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    • pp.40-48
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    • 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.

A Survey m Demand and Activation of Mobile Internet Business (무선인터넷 비즈니스 수요조사 및 활성화 방안)

  • 김철환;오광운
    • The Journal of Society for e-Business Studies
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    • v.7 no.3
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    • pp.1-19
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    • 2002
  • This research investigates several essential topics of m-business by conducting a questionnaire to the professional experts. The topics include the market structure and business, the demand for available m-business service and its development, the market size and market growth factors, the service fee, the core technologies and technology development prediction. This paper contributes to the development of m-business in that it provides criteria and policies for more active and efficient treatment of m-business market under IMT2000 environment and also offers guides and plans of m-business activation for both government and enterprise.

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Empirical Study on Unit Bias under the Flat Rate Pricing in the Korean Mobile Telecommunication Market (이동통신시장에서의 단위편향 소비행태 발생에 관한 실증연구)

  • Lee, Sang-Woo;Jeong, Seon-Hwa;Lee, Hyeongjik
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.41 no.2
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    • pp.229-237
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    • 2016
  • The purpose of this paper is to empirically identify whether unit bias exists or not under the flat rate pricing in the Korean mobile telecommunication market and to give the desirable form of pricing plans for minimizing this irrational behaviors. Our results show that with the flat rate pricing consumers tends to make more voice or data traffic over their optimal consumption level, meaning the existence of unit bias in the Korean mobile market. These results imply that under the current pricing plans subscribers may pay higher monthly fee than their optimal cost which maximizes their utility, for using the telecommunications service. Thus, policy makers need to consider adopting mobile operators' segmentation of the flat rate pricing plans for the reduction of subscribers' telecommunications costs and the improvement of consumer welfare.

An Analysis on Patients Trend and Income of Primary Care Clinic (일차 진료의원의 진료수입의 형평성 분석연구)

  • Lim, Sun Mi;Im, Geum Ja;Park, Kwan Jun;Park, Yoon Hyung
    • Health Policy and Management
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    • v.24 no.1
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    • pp.92-99
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    • 2014
  • Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

Current and Future Foodservice Management Performance in Child-care Centers (영유아 보육시설의 급식 관리 실태 및 개선방안)

  • Chang, Hye-Ja;Park, Young-Ju;Ko, Eun-Seon
    • Journal of the Korean Dietetic Association
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    • v.14 no.3
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    • pp.229-242
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    • 2008
  • This study examined foodservice management performance in child-care centers and suggests ways in which meal service quality can be improved. Questionnaires were distributed to 51 child-care facilities. The majority of respondents were facility directors (dietitians) and their facility type was tax-paid (92.2%). The dietitian response rate was 51.0%, and the majority (96.2%) were hired with co-management status, visiting a facility once a week (76.0%). Only 52.1% of the facilities had menu planning by a dietitian, and improvements were needed in terms of planning menus with standardized recipes, especially for infant meals. The monthly food cost per child was 47,394 won, and the labor cost for a co-management dietitian was 3,670 won per child, indicating 21.8% and 1.8% of the tuition fee, respectively. Other necessary improvements included: more reliable food purchasing management, securing additional foodservice equipment, and better sanitation management. In addition, respondents rated the following as requirements to ensure high quality meal service: 'modernized foodservice equipment and facilities', 'government financial support', and 'information on nutrition and foodservice management provided by dietitians'. Based on the study results, the following are recommendations for improving meal service quality in child-care centers: Dietitian placement should be extended to facilities of over 50-capacity in addition to their current placement in facilities of over 100-capacity, and co-management dietitians should have their control span restricted to two facilities instead of five. Finally, nationwide nutrition support plans and nutrition education programs should be developed and implemented by dietitians, and their roles should be extended to foodservice mangers as well as nutrition teachers.

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A Mobility Service for the Transportation Vulnerable Based on MyData (마이데이터 기반 교통약자 이동지원서비스 모델)

  • Choi, Hee Seok;Lee, Seok Hyoung;Park, Moon Soo
    • KIPS Transactions on Software and Data Engineering
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    • v.12 no.1
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    • pp.31-40
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    • 2023
  • Various policies and services are being implemented in Korea and other countries, such as the expansion of convenience facilities for mobility support, the provision of special means of transportation, and the establishment of public transportation route plans and fare policies based on data and AI-based movement pattern analysis to ensure the mobility rights of the weak in transportation. However, A research is still needed to improve service convenience in order to more conveniently use the desired means of transportation in a necessary situation from the viewpoint of the transportation vulnerable. This study examines the policies and services for the promotion of mobility for the transportation disadvantaged, and presents a MyData-based service model for mobility support for the transportation disadvantaged. In the proposed service model, the transportation-disabled person can freely choose and use the means of transportation according to individual circumstances, and receive the same transportation welfare voucher benefits provided by the state or government. The proposed service model defines the MyData platform that supports the safe collection and use of personal data, the authentication of traffic welfare recipients based on MyData, and the payment function for fee settlement after using the service as key components. In this research, the service satisfaction from the user's point of view was investigated by implementing the proposed service model and providing a demonstration service for the transportation vulnerable in Daejeon.

Comparison of Related Influencing Factors on Medical Services Satisfaction between General Dental Patients and Orthodontic Patients (치과 교정치료환자와 일반치료환자의 의료서비스 만족도 관련요인)

  • Lee, Dong-Geon;Han, Sam-Sung;Yoo, Wang-Keun
    • The Journal of the Korea Contents Association
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    • v.18 no.6
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    • pp.257-266
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    • 2018
  • This study was carried out to examine comparison of relating influencing factors on medical service satisfaction between general dental patients and orthodontic patients and to improve quality of the medical services by the treatment type of the visit. The data were collected from 421 patients who visited dental clinics and hospitals in Daegu and Gyeongbuk region, using self-administered questionnaire for the period from Sep 1 to Sep 30, 2015. The multiple regression showed that the medical staff and medical fee were common statistically significant independent variables to influence service satisfaction in both groups, however, fear in the treatment was added to statistically significant variables in only the orthodontic patients. Therefore, based on the provision of high - quality medical services and adequate medical care for patients' satisfaction, comprehensive plans including tailor-made counseling management and reducing the fear of dental treatment for general dental patients should be needed.