• 보건행정학회지
• /
• 제27권3호
• /
• pp.211-218
• /
• 2017

Background: Korea set up new diagnosis related group (DRG) as demonstration project in 2009. The new DRG was reformed in 2016. The main purpose of study is to identify the effect of reform on accuracy of payment. Methods: This study collected inpatient data from a hospital which contains medical information and cost from 2015 to 2016. The dependent variables were accuracy of total, bundled, unbundled payment, and payment for procedures. To analyze the effect of reform, this study conducted a multi-variate regression analysis adjusting for confounding variables. Results: The accuracy of payment increased after policy reform. The accuracy of total, bundled, unbundled payment, and payment for procedures significantly increased 3.90%, 2.92%, 9.03%, and 14.57% after policy reform, respectively. The accuracy of unbundled payment showed the largest increase among dependent variables. Conclusion: The results of study imply that policy reform enhanced the accuracy of payment. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG.

• 보건행정학회지
• /
• 제23권4호
• /
• pp.326-342
• /
• 2013

Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

• 보건행정학회지
• /
• 제33권4호
• /
• pp.379-388
• /
• 2023

This study aims to propose the implementation of innovative payment models in Korea in order to promote the financial sustainability of the national health insurance system by reviewing the current status of the payment system in Korea and examining other countries' experiences with various innovative payment models. Korea primarily uses a fee-for-service payment system and additionally uses various payment systems such as case payment, per diem, and pay-for-performance. However, each payment system has its limitations. Many OECD (Organization for Economic Cooperation and Development) countries have pointed out the limitations of existing payment systems and have been attempting various innovative payment models (e.g., add-on payment, bundled payment, and population-based payment). Therefore, it is essential for Korea to consider innovative payment models, such as a mixed payment model that takes into account the strengths and weaknesses of each payment system, and to design and pilot these models. This process requires stakeholders to work together to build a social consensus on the implementation of innovative payment systems and to refine legal and systematic aspects, develop an integrated health information system, and establish dedicated organizations and committees. These efforts towards innovative payment models will contribute to developing a sustainable health insurance system that ensures the public's health and well-being in Korea.

• 한국병원경영학회지
• /
• 제23권1호
• /
• pp.51-64
• /
• 2018

Purposes : In February 2014, the government said that the National Health Insurance Service (NHIS) will enforce plan for reducing the financial burden from two major non-covered services including physician surcharges and private room charges, the main causes to increase uninsured, by 2017. The purpose of this study is to analyze the policy effect that performed so far by comparing out-of-pocket payment rates of policy process Methodology: This study analyzed admission medical expenses that occurred from January 2013 to March 2016 at a upper grade general hospitals in Daejeon. Number of study subjects were 134,924 and the data were analyzed with SPSS 22.0 program by using frequency, percentage, mean, standard deviation, ANOVA. The effect of two major non-payment improvement plan on out-of-pocket rates was ascertained via generalized estimating equation. Findings: Out-of-pocket payment rates was statistically significantly declined 2.7 percent than enforcement ago. Also, out-of-pocket payment, physician surcharge, the proportion of out-of-pocket payment of hospital room charge to out-of-pocket payment was statistically significantly declined. However, a further analysis of the cause of the decline in total medical costs is needed. Practical Implications: Physician surcharges and private room charges improvement policy had a positive effect on the decline of out-of-pocket payment rate. The policy of physician surcharges was very effective after the first policy enforcement but it was less effective to medical aids and near poor that was a more greater coverage than national health insurance. Since the policy has not been finalized, we have to continue a research for the successful implementation of the policy.

• 무역학회지
• /
• 제44권3호
• /
• pp.191-202
• /
• 2019

Despite innovative efforts to accommodate changes in the payment environment, the new types of settlement risks that are emerging require preemptive and proactive responses. Therefore, Korea should complement and develop large-value funds payment system operation and risk management policies by introducing international standards and linking with advanced financial institutions. This study examines the major issues such as the development process and characteristics of the large-value funds payment system of the two countries, the operation policy of the central bank, and the risk management policy by comparing the US Fedwire with the Korea Bok-Wire+. In addition, policy implications are suggested for efficient operation and development of Bok-Wire+.

• 보건행정학회지
• /
• 제27권2호
• /
• pp.139-148
• /
• 2017

Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

• 디지털산업정보학회논문지
• /
• 제19권3호
• /
• pp.45-60
• /
• 2023

The purpose of this study is to explore factors that affect millennials and generation Z customers' perception on intention to recommend to use the digital payment services and invesetigate factors that affect perception on sustainable growth of the digital payment services. This study applied the following research questions: i) how perceived brand value, easy to use, personalization, open to public, and social value affect intention to recommend to use the digital payment services and ii) how perceived public policy, promotional strategy, and prspects affect intention to recommend to use the digital payment services to others. This study conducted an online survey. This study applied factor, ANOVA, and regression analysis to test hypotheses. The results of this study found that effects of personalization, open to public, and social value on intention to recommend the service showed significance in the case of millennials, while effects of brand value, easy to use, and open to publis on intention to recommend the service showed significance in the case of generation Z. The results provide managerial and policy implications on how to apply better strategies and pepare policies to enhance adoption of the digital payment service in cases of millennials and generation Z.

• 한국병원경영학회지
• /
• 제3권1호
• /
• pp.238-260
• /
• 1998

This article describes the theoretical foundations of government policy for hospitals in terms of correcting market failure and enhancing equity. It then discusses the characteristics that desirable payment systems should have, and the effects of the DRG-based prospective payment system on hospital behavior, its financial performance, hospital industry, and health care expenditure. The rationales and impacts of other public policies for hospitals such as antitrust and fair trade regulation, dissemination of practice guidelines and hospital mortality information, regulation of hospital capital investment, and tax policy are also discussed.

• Journal of Information Technology Applications and Management
• /
• 제25권1호
• /
• pp.105-124
• /
• 2018

The usage level of SMEs' win-win payment system is still lower than originally expected. In order to find the answer, we studied SMEs' usage performance of win-win payment system and analyzed the influencing factors of SMEs' usage level of win-win payment system. This study found that the more SMEs utilize win-win payment system, the higher they achieve the desired performance in finance, customer, process, learning and growth perspective. And this study found that usage level of win-win payment system is high in order of large corporations' pressure, government policy, and SMEs' readiness. This study is expected to improve win-win growth by increasing usage level of win-win payment system between large corporations and SMEs, while establishing desirable ecosystems.

• 농업과학연구
• /
• 제35권2호
• /
• pp.247-262
• /
• 2008

The purpose of this study is to evaluate farmer's general contents on the current direct payment schemes and to derive some improvement measures, based on the survey data for the three types of direct payment schemes currently executed in Korea; Rice Farmer's Income Support, Early Retirement Aged Farmer's Support and Less Favored Area Direct Payment. In recent years we have introduced diverse direct payment schemes that are expected to have immediate effects in a short term period without enough preparation of the policy, which raises some contradiction between the agricultural policy and the original purpose of the direct payments. The result shows some important revisions should be made related the direct payment schemes, such as farmer's income stability through the improvement of unit payment and the payment length jointed with criteria of the payment, in addition to keeping up multifunctionality of agriculture and enhancing the effect of structural adjustment in agriculture.