• Journal of Society of Preventive Korean Medicine
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• v.8 no.2
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• pp.129-139
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• 2004

This paper analysed the RBRVS for a doctor's consultation by measuring the time consumed in outpatient consultation, and compared the time among medical doctors, dentist, and oriental medical doctors. The time used in consultation could be a proxy for measuring RBRVS for medical services because it is the only common factor we observe in three different clinical settings. The results show that the optimal RBRVS for consultation is 183.22 for medical doctor, 99.12 for dentist, and 236.17 for oriental medical doctor. This implies the current fee schedule for consultation should be revised as 10,740 Won for a visit to medical doctor, 5,808 Won for dentist, and 13,832 Won for oriental medical doctor.

• Health Policy and Management
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• v.2 no.1
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• pp.1-16
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• 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.

• Health Policy and Management
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• v.5 no.2
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• pp.202-229
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• 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.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.105-125
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• 2005

Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.2
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• pp.283-293
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• 2002

Purpose: The purpose of this study was to define cost-countable perioperative nursing activities and to analyze the cost of each nursing activities based on the Resource-Based Relative Value Scale (RBRVS). Method: Researcher and 3 research assistants observed and documented the 83 operating patients in order to measure nursing time for each of the perioperative nursing activities. And then, 35 operating room nurses with at least one year of perioperative nursing experience were observed for the RBRVS of perioperative nursing activities. Finally, the direct and indirect nursing costs were estimated. Result: Nursing costs of 25 nursing activities were estimated using the RBRVS. Most expensive nursing activities were delivery of the instrument and implement for OP team (9,780 won per hour) and behavior of wash, pack, disinfect the instrument (6,770). Conclusion: Based on the relative values of each perioperative nursing activities estimated in this study, proper medical reimbursement system should be established in a near future.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.253-280
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• 1999

A cost analysis for hospitalized patients was performed based on the RBRVS in order to determine an appropriate nursing fee schedule. The study was conducted through three phases as follows: 1) Nursing activities provided for the inpatients currently in Korea were identified and classified using a taxonomy which was developed by our research team through the Delphi process. 2) The resource-based relative points for every nursing activity according to nursing time, mental effort and judgement, technical skill, physical effort and stress were determined through a survey of 300 clinical RNs working at 5 tertiary hospitals from May 25 to July 25. 1998. 3) The nursing cost of every nursing activity for hospitalized patients was estimated based on the RBRVS. As a result, 136 nursing activities were identified and classified by nursing processes and nursing domains. However, our classification system of nursing activities should continue to be refined, and all nursing practices should be standardized. The nursing activities were given resource-based relative points ranging from 100 to 400 points, then each nursing activity was assigned a value for the RBRVS, which was determined by the exponential function of 2resource-based relative point/100. Thus, a value of 2 was calculated for 100 points, 4 for 200 points, 8 for 300 points, and 16 for 400 points. Meanwhile, the unit cost of nursing was calculated as 170 Won. The nursing cost of 136 nursing activities was estimated using the RBRVS as shown in