• Title/Summary/Keyword: fee schedule

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A Study on the status and improvement of construction management in Daegu Gyeongbuk Institute of Science & Technology (대구경북과학기술연구원의 건설사업관리 적용 현황과 향후 발전 방향에 관한 연구)

  • Kim, Hwa-Bong
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • 2007.11a
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    • pp.32-38
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    • 2007
  • Recently The public project ordering is a tendency increasing of CM service because of the visible and affirmative effect in the CM which is advanced meanwhile. The CM services of project all phase excepts a planning business are performed. But recently the CM services of project all phase including a planning business are increasing every year. To develop CM must be prepared the system plans concerned with the CM application from planning phase, actuality maintenance of CM fee-estimation standard, understanding conversion of participation subjects, etc. But, unexpected actuality the problems occurs when the CM business is performing. The purpose of this study are to present the solution to the problems concerned with the planning business management, additional business by owner, schedule control and establish the plan to perform CM services efficiently in the public sector through analyzing the case of CM application in Daegu Gyeongbuk Institute of Science & Technology.

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Factors Affecting the Length of Stay of Long-Stay Medical Aid Inpatients in Korea: Focused on Hospitalization Types in Long-Term Care Hospitals (장기입원 의료급여 환자의 재원일수에 미치는 영향요인: 요양병원 입원유형 중심으로)

  • Yun, Eun Ji;Lee, Yo Seb;Hong, Mi Yeong;Park, Mi Sook
    • Health Policy and Management
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    • v.31 no.2
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    • pp.173-179
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    • 2021
  • Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

A Study of the History of Korean Public Library after the Korean Liberation Day - An Emphasis on the influence of public Libraries System under the Japanese Imperialism- (광복이후 한국 공공도서관사 연구 -일제하 공공도서관제도의 영향을 중심으로-)

  • Kim Po Ok
    • Journal of the Korean Society for Library and Information Science
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    • v.20
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    • pp.65-125
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    • 1991
  • The study has tried to analize and appraise how did public library system under the Japanese imperialism affect the establishment and managemant of Korean public libraries. To achieve the purpose of the above-mentioned study, the contents of $\ulcorner$Japanese library statute$\lrcorner$ under Japanese imperialism and the current $\ulcorner$Korean library law$\lrcorner$ have been mutually compared, at the same time, the vestiage of Japanese imperialism in view of the establishment, personnel administration and reading systems have been concretely investigated, analyzed and compared. The conclusions obtained from the above are as followings. 1. In those days of the Korean Liberation, the situation of Korean public libraries was such as it under the Japanese rule and so, their names were only changed. However, as a part of its independent activities, the national library have once carried out the various programs such as the training of professional librarians, the establishment of the new classification schedule and the chief Librarian and deputy Librarian from the professional librarians in the office regulations, and they were well worth being the good examples for today's Korean library circle. Though the Goverment of the Republic of Korea had been formally established, the situation of the library circle was very dull owing to the Korean war for a long time. In 1963, $\ulcorner$The Korean library law$\lrcorner$ was promulgated, but the establishment of public libraries did not give satisfactory results because of the institutional fragility. In the 1980's the importance of library was embossed from the viewpoint of life-long education and the number of libraries was increased. However, there were still the remaining vestiges of Japanese library system in the practical library services. 2. After the Korean Liberation, the influnces of public library system under the Japanese imperialism showed in the office regulation of national library and the Korea library Law were also in the legal mechanism. In particular, the regulations of $\ulcorner$The staff-member of public library$\lrcorner$ and $\ulcorner$Admission fee of public library$\lrcorner$ including the chief librarian have referred to the library system under the Japanese imperialism since the liberation day to date. 3. At that time of the Korean Liberation, the U.S.Military Government Office had decided that the public library administration should be attached to the administration of local and internal affairs in accordance with the Japanese administative system. As a result, the public libraries had been forced to be indirectly affected by public library system under the Japanese imperialism for twenty years since the Liberation. 4. Since the Liberation, the personnel adminstration of public library has been so far on the steps of model under the Japanese imperialism. As the result of the field survey, the position standards of local chief librarians, non-professional character, the extra post system and the preponderant appointment of non-professional offices have analyzed by the influence of Public library system under the Japanese imperialism. Therefore, the Government authorities-concerned must readjust the standards of qualification and the divided duties corresponding to the position of public library staff members and to stipulate expressly in the revised library law. In addition, the regulation of the admission fee should be also actively detected for the free adminssion of library users. 5. Since the Liberation Day, the reading methods of public library have been so far similar to reading method under the Japaness imperialism. For example, the admission fee levied, the complicated procedures of using books including entrance and exit of a library, no-admission system, the limited lending books, the deposit system of outdoor lending books and the surety liable jointly and severally are originally caused by bureaucracy of under the Japanese imperialism. Therefore, the public libraries should make an offer space and opportunities which can enjoy freedom to the gull in future. The procedures and standards of library users will be simplified, if possible. As the above-mentioned, the actual conditions of Korean public libraries have been examined and analyzed. As the result of it, there are still the remaining vestiges of public library system under the Japanese imperialism in the establishment and management of the nation-wide public libraries. Such the remnants are an obstacle to the democratic development of public libraries and so, the authorities-concerned should take the proper-measures as soon as possible.

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Development of Nursing Costs by Nursing Activities in Clinical Nurse Specialist (전문간호사 간호행위에 관한 간호수가체계 개발)

  • Kim, Yoon-Hee;Lee, Hyang-Yeon;Han, Sang-Sook;Shin, Hye-Sook;Lee, Myung-Hee;Kim, Sook-Neoung;Lee, Hye-Jin;Kim, Hye-Sook;Choi, Hyes-Sun
    • Journal of East-West Nursing Research
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    • v.13 no.2
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    • pp.197-207
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    • 2007
  • Purpose: This study was carried out to deveop nursing costs and to substantiate the application of appropriate activity-based nursing costs for the current clinical nurse specialists. Method: The study sample was a group of 8 home health care team of the tirtiary Hospital in Korea. The data was collected from September 2003 through December 2004. The statistical analysis was done by SPSS PC 11.0 program and calculated mean and the standard deviation. In Lee(2003)'s nursing activity analysis, nursing activities were classified into two major classification, 19 domains and 70 activities. Each activities was calculated using its work validity, physical effort, psychological effort, stress as a intensity, and the necessary time. The simple work costs was calculated the work wage per minute and the necessary time. The work load intensity was calculated using the work wage per minute and the necessary time work load intensity/100. Results: In this study, the work wage was 283 won per minute. The work validity ranged from 2.71-4.00. The highest simple work cost/work load intensity cost was 12,735won/47,374won for research activity, 10,700won/27,499won for bedsore care, and 9,727won/35,114won for deathbed care. The lowest simple work cost/work load intensity cost was 2,123won/2,038won for intramuscular injection, 2,210won/2,166won for hypodermic injection, and 2,210won/1,547won for a application of medicine(or ointment or cream). Conclusions: It revealed that the nursing cost should be considered validity, physical effort, psychological effort, stress as a intensity, and necessary time. Therefore, It is necessary to calculate nursing cost systematically based on activities.

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What Can Koreans Learn from the Dutch Experiences in Reforming the Health Insurance System? (한국의료보험제도(韓國醫療保險制度)의 개혁필요성(改革必要性)과 네덜란드의 경험(經驗)이 주는 교훈(敎訓))

  • Kwon, Soon-won;Sunwoo, Duk
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.47-69
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    • 1990
  • The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.

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Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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Status of Infectious Disease Inpatients at Long-Term Care Hospitals in Korea (국내 요양병원의 감염병 입원환자 실태 분석)

  • Bang, Ji Ya;Lee, Hanju;Son, Yedong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.134-143
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    • 2020
  • This study investigated the status of infectious disease inpatients at long-term care hospitals in Korea. A descriptive study was conducted on patients with 14 infectious diseases at 798 long-term care hospitals during 2016-2017. The number of infected patients, total admission days, and total medical expenses were higher in 2017 than in 2016. The most common infectious diseases were enterocolitis due to Clostridium difficile, influenza, and scabies. The number of hospitals with patients who had enterocolitis due to C. difficile and resistance to carbapenem was higher in 2017 than in 2016. Hospitals with 150-299 beds had higher numbers of infectious disease patients than those with under 150 or over 300 beds. Therefore, intensive efforts are needed to control the most common diseases at long-term care hospitals, such as enterocolitis due to C. difficile, influenza, and scabies. It is recommended to apply relevant guidelines related to infection control management as well as implement educational programs. It will also be necessary to develop applicable infection monitoring standards and support the facilities and health workforce of long-term care hospitals under 300 beds through an effective infection surveillance system.

A Study on the Reasonable Personnel Management of Radiology Department -Centering around the General Hospitals in Seoul- (진단방사선과(診斷放射線科)의 적정인력(適正人力) 관리(管理)에 관(關)한 연구(硏究) -서울시내 종합병원(綜合病院) 중심(中心)으로-)

  • Chung, Soon-Kuy
    • Journal of radiological science and technology
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    • v.11 no.2
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    • pp.27-64
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    • 1988
  • Most hospital administrators in our country have doubted whether or not the size of their hospital personnel staffs, and the personnel management styles implemented are efficient or not. Actually, increased personnel expenditures due to sophisticated specialization of medical practices has become the biggest hospital expense. Therefore, it is said that hospitals can be run move efficiently by implementing reasonable management strategies for hospital personnel management. In this paper, the departments of diagnostic radiography in 16 general hospitals in Seoul, which were classified into 4 groups by the scale of hospital beds, were used as sample cases. Then, the data for the number of X-ray examination by diagnostic item was collected from sample hospitals. The unit hour spent on X-ray examinations in each diagnostic service was quoted from "A Study on setting-up of the relative value units of medical services and on the structure of current fee schedules" written by Mr. Ik Je Seong. The data analysis results are as follows; First, the number of hours per day spent on X-ray examinations in 13 hospitals out of 16 hospitals, was shorter than the general daily working hours (8 hours). Second, in the morning there was not enough time to work for X-ray examinations required, with the available manpower. In the afternoon, however, the situation was diametrically opposed to that in the morning. Third, in light of above results, though most hospitals employ sufficient personnel for the quantity of the actural work, they were always short-handed where their works were performed Fourth, this study tells us that there is a maldistribution of the work in the schedule : too much work for the available personnel in the morning. The following recommendations are resulted from the data analysis described above. First, it is recommended that all out-patients coming again, except specific patients(G. B. or I.V.P. etc) who have to have their X-ray examinations on an empty stomach in the morning among out-patients, be required to visit the hospital in the afternoon. Second, it is recommended that all new out-patients be required to make a reservation in order to equalize the number of patients throughout the day. Third, it is recommended that all in-patients, except specified patients, be arranged to have their X-ray examinations in the afternoon. Fourth, it is recommended that part time workers be employed during peak hours. This recommendation, if applied in a wider scale, would allow hospitals to overcome the problem of the maldistribution of work and personnel, and then more efficient hospital management through the appropirate personnel management procedures could be expected.

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Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.