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A Study on Accounting for Nursing Cost by Korean Diagnosis Related Groups (K - DRGs) (종합병원(綜合病院)의 간호행위양상(看護行爲樣相)에 따른 간호원가(看護原價) 산정(算定)에 관(關)한 연구(硏究))

  • Oh, Hyo-Sook
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.5-46
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    • 1989
  • The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

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A Benchmarking Study on CM Fee Estimation (해외사례 벤치마킹에 기반한 국내 CM 대가체계 개선 시사점 도출)

  • Kim, Sang-Bum;Lee, Jeong-Dae;Kim, Jae-Wook
    • Korean Journal of Construction Engineering and Management
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    • v.9 no.1
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    • pp.96-106
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    • 2008
  • The Korean Construction Industry significantly contributed to the Korean economic development not only by preparing the domestic infrastructure but also by successfully conducting various international projects. However, major incidents such as the collapse of Sung-Su Bridge and Sam-Pung Department Store along with stagnation of Korean Economy have raised questions about underlying systematic problems of the Korean Construction Industry. As a solution to resurrect the Korean Construction Industry, the Construction Management (CM) system introduced in late 1990's and increasingly utilized as an innovative delivery system. Despite of the fast growth of CM, the performance of CM has not been up to the hype and low CM fee has been identified as one of the main reasons of unsatisfactory CM performance. Therefore, this research attempted to propose ways of improving 'CM Fee Guidelines' published by Korean Ministry of Construction and Transportation by conducting a benchmarking study on Global Standards of estimating CM Fee. International organizations benchmarked in this research include CMAA, ASCE, DOL, DOE, etc. Various investigation and analysis revealed that Korean 'CM Fee Guidelines' need to significantly modified comparing to Global Standards. This research also tried to prepare recommendations to improve the CM deliver system focusing on the 'Method of CM Fee Estimation' and Selection of a CM firm as an owner's agent.

Relationship Between Type of Medical Institutions According to the Equipment List and Inspection Fee Computed Tomography (의료기관 종별에 따른 전산화단층촬영장비 보유현황과 검사료간의 관계)

  • Kim, Min-Cheol;Lim, Cheong-Hwan;Joo, Yeong-Cheol
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.315-322
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    • 2014
  • This study demonstrates holding condition of CT by medical institution classification and by season, and examination fee in Korea currently to quantitatively understand frequency of examination region by change of CT equipment, domestic growing trend and change of distribution and using rate. Recent 10 years of CT holding condition by medical institution classification (Tertiary hospital, General hospital, Hospital, Clinic, Dental hospital, Dental clinic, Hospitalized health center) and by year (2003-2012), and CT examination fee of distribution of medical institution by year is surveyed. The holding ratio of Tertiary hospital level and General hospital level is 32.7% in 2003 and 33.0% in 2012. Whereas, Hospital and Clinic level is 74.2% in 2003 and 66.8% in 2012, which takes approximately 70%. Based on data in 2012, it is 82.2% of total examination fee in Tertiary hospital and General hospital, while 17.5% in hospital and clinic. CT holding rate of Hospital level is increasing, while Clinic level is decreasing. Approximately 80% of CT examination fee is claimed by Tertiary hospital and General hospital. Therefore, there is a significant correlation between CT holding condition of medical institution classification and examination fee. Particularly, correlation between CT holding number of Tertiary hospital and examination fee is significant (p<.001). The more CT holding number, the higher the amount claimed examination fee.

A Problem of Disqualified Fee Imposition Standard in Public Cremation Facilities on Internet Reservation of e-Haneul Funeral Total Information System and an Improvement Proposal (공설화장시설 사용료 부과기준 부적정이 e-하늘 장사종합정보시스템 인터넷 예약에 미치는 문제점 및 개선방안)

  • Choi, Jae-sil;Kim, Jeong-lae
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.16 no.3
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    • pp.163-172
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    • 2016
  • This study conducts an analysis of a problem on internet reservation of e-haneul funeral total information system by disqualified fee imposition standard in public cremation facilities through research and investigation focusing on the operational realities and an ordinance related to public cremation facilities made by each local government across the country, and then is to suggest a policy proposal to improve the drawn problem. As a result of the analysis, as a way to improve the drawn problems, this study suggests a policy proposal that prevents an illegal camouflaged move-in to reduce fee by restricting residence period in requirement of local residents inside the jurisdiction who can use public cremation facilities, raises fee of public cremation facilities of local residents inside the jurisdiction into the optimum level that is set cheaper than production cost, and unifies age norm of an object to apply adult fee in the central government about a difference of age norm of an object to apply fee of adult with the highest availability of public cremation facilities between local governments, resolving a fee difference through fee cutting of local residents outside the jurisdiction priced higher than production cost.

THE ADDITIONAL POINT SYSTEM OF NATIONAL HEALTH INSURANCE FOR DENTAL TREATMENT IN PATIENTS WITH A SPECIAL HEALTH CARE NEED IN KOREA (한국의 장애인 환자 치과 진료를 위한 국민 건강 보험 가산제도의 종류 및 청구 현황)

  • Kwon, Doyoun;Nam, Okhyung;Kim, Misun;Choi, Sungchul;Kim, Kwangchul;Choi, Jaeyoung;Lee, Hyo-Seol
    • 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.

Interconnection Fee or Access fee? - Focusing on ISP-CP settlement dispute - (상호접속료인가, 망 이용대가인가? - ISP-CP간 망 연결 대가 분쟁 중심으로 -)

  • Cho, Dae-Keun
    • Journal of Internet Computing and Services
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    • v.21 no.5
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    • pp.9-20
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    • 2020
  • This study redefines the networks' connection behaviors and the terms confusion over the settlement in Netflix-SK Broadband's dispute through domestic and foreign legal references. Conflict parties, academics and the media use the terms "interconnection fee" or "Access fee" without uniformity, and in some cases mixes for strategic purposes. The use of different terms for the same phenomenon (or vice versa) has a high need for research in that it makes it difficult to reach a unified approach to the problem, to discuss it productively and rationally, and, moreover, to resolve disputes. Therefore, this study cross-referenced/analyzed terms related to network utilization and connectivity, namely "Use", "Access", "Interconnection" and thus cost-related terms as a counter-pay. In addition, it suggests that interconnection fees and access fees should be used separately, and allows them to function as a starting point in resolving future ICT sector issues. As a result of this study, the price against the network access/use between Netflix and SK Broadband is access fee or retail price, and proposes to be used uniformly in the term "interconnection fee" only for fees incurred in interconnection between ISPs that possess or operate networks.

A Survey on the Visitor's Cognition of Admission fee in National Park - The Case Study of Songnisan National Park - (국립공원 입장료에 대한 이용객 의식 조사 - 속리산국립공원 이용객을 대상으로 -)

  • 김용근;조중현;박태희
    • Korean Journal of Environment and Ecology
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    • v.16 no.3
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    • pp.261-270
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    • 2002
  • The purpose of this study is to survey and analyze of the visitor's cognition of admission fee collection system in National Park. To accomplish the purposes, a questionnaire survey was employed in Songnisan National Park. The contents of questionnaire consist of the socioeconomic characteristics and the types of visiting, the activity, the cognition of admission fee collection system.339 samples of total 345 respondents were used for final analysis. As a result of the analysis, the socioeconomic characteristics and the types of visiting, the visiting purpose were showed similar trends with results from other National Park visitors survey. Most of respondents didn't recognize the raise of admission fee and how to use the admission fee. And they recognized that it is too expensive. Most of respondents recognized the joint collection of admission fee but they were strong against it. About the range of cultural assets in National Park, the cognition of 'Only Buddhism's assets in temple' was almost equal with the cognition of 'It includes not only cultural assets of inside and outside temple but also thick forest in National Park'. But most of respondents were strong against the collection of admission fee of cultural assets.

Fee-based Field Trips to Jirisan National Park; Eco-guide Led Programs

  • Cho, Kye-joong
    • Journal of Korean Society of Forest Science
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    • v.96 no.5
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    • pp.543-550
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    • 2007
  • Arguments against charging fees for use of recreational forests and parks generally rest on the assumption that the public sector has the responsibility to provide as many recreational opportunities as it can to all visitors in Korea. The entrance fee in recreational forests allowed some governmental resource management agencies to keep a portion of user fees generated on-site, instead of returning all revenue to the general treasury. Funded primarily through entrance, activity, parking, and mountain villa-use fees, this legislation has been successful in reducing the maintenance backlog for participating agencies. However, it is unclear what effect user fees might have on visitors attending interpretive programs and the benefits that agencies might receive from implementing this policy. From this point of view, this study is a similar case at the Visitor Center and Species Restoration Center at Jirisan in terms of fee-based field trips to the places. In this research, two hundred twenty-three visitors at the Visitor Center and Species Restoration Center at Jirisan National Park answered questions about their trips from 2005 to 2006. Results indicted that the ecoguide not only increased visitor's appreciation of the resource, but also enhanced their perceptions of the Korean National Park Service (KNPS) fee policies.

A Study on the Program of Fee-Based Information Services for University Libraries (대학도서관을 위한 유료정보서비스 프로그램에 관한 연구)

  • Song Young-Hee
    • Journal of Korean Library and Information Science Society
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    • v.30 no.1
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    • pp.171-192
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    • 1999
  • Unlike the past, university libraries are able to provide specialized and differentiated information services due to the advent of information technology and telecommunication. Such services are essential not only to the primary users, such as professors and students in the universities, but also to the external users including corporations, researchers, and the general public. Now, university libraries as a means of resource sharing with communities should develop the services to play a role as a research and information center and expand such services to outside users who need the information services. Accordingly financial support is a necessity to provide the services, thereby fee-based information services are one of the devices for solving the financial burden and controlling outside users. This paper tries to present a program for fee-based information services which are able to be implemented by university libraries. Also the papers deals with the present conditions of fee-based information services provided by university libraries briefly and the goals of the program; coverage of subjects and types of materials for the program; organizations and staff; types of fee-based information services; management methods of program.

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

  • Han, Ki Myoung;Cho, Min Ho;Lee, Soo Jin;Chun, Ki Hong
    • Health Policy and Management
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    • v.23 no.4
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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.