• Health Policy and Management
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• v.12 no.1
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• pp.84-101
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• 2002

This study collected and analyzed the datum related to consultation fee in National Health Insurance Corporation and characteristics of dental clinics for 819 dental clinics in Daegu and Kyungpook districts to specify the distribution and concentration rate of health insurance consultation fee and the critical elements of insurance consultation fee income. The average health insurance consultation fee per one dental clinics is 77.2 million won and the case of women dentists is 78.7 million won. That is higher than 79.9 million won that the case of man dentist. According to age, under 39 is 85.5 million won that is highest, declining little by little above 60s the number decreased to merely 23.9 million won. And the dentists whose business years from 5 to 10 are the highest and declining gradually. The more of engaging members to dental clinics is the larger the income. The average insurance consultation fee of Daegu province is 69.3 million won, but that of Kyungpook is 89.6 million won. Decile distribution ratio of dental clinics consultation fee income is 0.526 and Gini coefficient is 0.303. Decile distribution ratio of Daegu district is 0.489, Gini coefficient is 0.320. This explain the larger inequality compared with Kyungpook(0.623, 0.273). With age, Gini coefficient of below 39 is 0.260, the higher age is, the larger the number is, up to abode 60 the coefficient is 0.504, the degree of inequality is most extremely. insurance consultation fee and the number of cases of consultation is related to the age of dentists, duration of practice, the number of dentists and staffs engaging and provinces. That is, the lesser the age is, the longer the years of engaging are, the more the number of dentists and staffs we, the larger insurance consultation fee income and the number of cases of consultations we. And the fee fur one case is closely related to age and provinces. The fee for one case is higher in lower age, and that of in Daegu dental clinics is higher than in Kyungpook.

• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.461-467
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• 2020

Industrial consultation is a kind of personal service for companies. The Industry-Academic Cooperation Foundation sets up a consultation contract in which a professor performs the consultation as the person in charge. Recently, there is an issue regarding taxation of the consulting fee paid to the professor; in short, there is no standardized practice for the imposition of income tax. In this study, we examine the characteristics of industrial consultation and present an acceptable taxation rule based on related laws. First, it is not appropriate to regard consulting fees as wage income, considering that there is no employment relationship between the Industry-Academic Cooperation Foundation and the professor. Considering that the base consulting fee amount is the same as the invention compensation, according to accounting practices, and that an employee invention is apt to be derived in the consultation, it is reasonable that the consulting fee should be regarded as wage income similar to employee invention compensation. As treating the consulting fee as wage income could end up reducing industrial consultations, the government should amend the income tax law to include industrial consultation as a type of other income.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.11-16
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• 2018

In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

• Health Policy and Management
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• v.27 no.1
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• pp.39-46
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• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

• Health Policy and Management
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• v.11 no.3
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• pp.71-88
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• 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.

• Health Policy and Management
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• v.6 no.2
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• pp.115-130
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• 1996

This study was performed to investigate the practical oriental medical expenses by the use of internal data of an oriental hospital due to the bias of medical insurance program data. The purpose of this study was to describe prevalent diseases of clinical department in the studied hospital, to analyze medical expenses structure and to verify the each cost share ration of expenses on insurer to insuree. Under this purpose, we analyzed actual medical expenses data of 1,611 hospitalized patients of the oriental medical university hospital with 150 beds that can be approached to internal data from Jan. 1, 1994 to Dec. 31, 1994. The major findings are as follows : 1. Upper five of most frequent diseases of admitted patients were Joul-Jung-Pung(55.5%), Yoo-Kak-Tong(7.3%), Yoo-/Tong(7.1%), Gu-An-Wa-Sa(2.7%) and sequale of Joul- Jung-Pung(2.4%) 2. In medical expenses structure, hospital ward fee was 47.1%, medication fee 41.3%, fee for procedure(acupuncture, moxibustion, negative therapy, physical therapy, etc) 11.1% and consultation fee 0.5%. In addition to the cost share ration of insuree & that of insurer was 75:25 respectly.

• Journal of Korean Academy of Nursing
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• v.48 no.5
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• pp.554-564
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• 2018

Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.11-38
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• 2012

The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.200-231
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• 2000

The price systems of the hospital drug services play key roles in the provision of quality services and the development of pharmacy service technologies. Under the premises, this study attempted to determine the costs of hospital drug service, to compare the costs calculated with the fees publicly fixed by the Government, and based on the results of the analysis, to propose directions for the improvement of the price systems. A Costing model for the study was developed based on the cost-fee relationship analysed of the Korean fee-for-service systems. Data on costs and workloads of the 25 hospitals were collected through survey forms designed for the costing' and analysis for the duration of 12 months of 1998. The results of the analysis show that a tremendous unbalance between cost and price levels of the drug services, and that overally the price level of the services is extremely low when compared to the costs of services. Based on these findings, this study suggests that unfairly high or low price level be corrected, and that service items newly developed and being practiced at tertiary hospitals, such as TDM and TPN consultation services, be compensated by fixing a proper level of price.