• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.4 no.2
• /
• pp.57-62
• /
• 2003

In order to implement SGR in Korea, it is necessary to analyse the factors affecting the increase of Korea Medical Insurance Cost. GDP and MEI may substitute the diverse factors affecting the Medical Cost Uprise. In this article, the GDP and MEI influence on the rates of fee schedule is measured when we implement SGR System in Korea. The various cases are made to analyse the rates of fee change. In Korea, if we implement the SGR system successfully. we should make a considerate formula using GDP and MEI because the rate of change in GDP and MEI is much more bigger than that of U.S.

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

• Health Policy and Management
• /
• v.2 no.2
• /
• pp.152-178
• /
• 1992

This study focuses on making recommendations for the improvement of poor emergency medical services or EMS in Korea. Problems of the current EMS system is widely reviewed. As an alternative of the current system, a franchises system is introduced to EMS. A feasibility study of the new system is carried out as follows. 1) The current EMS system shows such problem as; - Inadequacy of emergency medical fee schedule, - Shortage of emergency medical resources, - Concentration of emergency medical facilities in metropolitan area, - Unestablishment of training program for emergency personnel, - Inappropriateness of patients' behvaviro pattern in emergency care system. 2) Recommendations for the improvement of EMS are as follows: - Well organized communication and transportation system needs to be established by utilizing all the availabl EMS is to be devised for the provision of appropriate emergency care. - A franchises system can be widly adopted so that private organizations are willing to establish a free standing emergency center. - Emergency care fee schedule of the franchises system needs to be appropriate for the system to provide high standard medical services.

• Journal of Technologic Dentistry
• /
• v.16 no.1
• /
• pp.78-104
• /
• 1994

Under the fee for service schedule of Korean health insurance system, rational fee for dental laboratory products based on the cost is required to be formulated. The purpose of this study was to find actual cost of dental laboratory products in case of a University Hospital. Materials of this study were used as follows : 1. Balance sheet at Dec. 31, 1992 and profit and loss report of the year 1992 of the sample hospital 2. Performance report of dental laboratory department. 3. Purchasing and other accounting bills of dental laboratory materials. The following methods were used. 1. Actual cost finding of dental laboratory department was performed. 2. Work sampling methods were used for measuring standard working time by the process of working. 3. To porcelain fused to metal crown(non-precious), Relative value of the cost of dental laboratory products was calculated as 1.00. 4. Fee and cost of those products were compared on the basis of Relative values. The results of the study can be summarized as follow : 1. Overall, it took longs time than other items. to product denture-related items. 2. When several teeth are made in a time, average production time is much sorter than when one tooth is made in a time. 3. The relative price cost of Dicor cast crown and denture related items are higher than the criterion items. 4. The material cost occupies average 11% out of the total price cost, proportion of personnel expenses is average as 60.0%. 5. Some of the components consisting of the price cost are not reflected adequately in setting the level of the reimbursement price. 6. Relative values of dental laboratory products price cost are varied in the range from 0.05 to 2.83, overall, the reimbursement price of dental products appears not to reflect adequately the price cost. On the basis of this study results, the following ideas would be suggested : 1. Fee Schedule of dental laboratory products should be renovated in order to reflect their costs. 2. Dental laboratory product manufacturers should be enlarged for the economy of scale which may be useful for cost- containment. 3. Dental laboratory producters themselves are required to be standardiqed according to the categories of skill.

• Journal of Korean Academy of Nursing
• /
• v.37 no.3
• /
• pp.373-380
• /
• 2007

Purpose: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. Method: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). Results: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. Conclusion: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.

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

• Health Policy and Management
• /
• v.31 no.3
• /
• pp.261-271
• /
• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• Journal of Society of Preventive Korean Medicine
• /
• v.12 no.3
• /
• pp.21-34
• /
• 2008

Objectives : This paper analysed the alternative methods of calculating conversion factor for oriental medicine in the National Health Insurance and estimated the conversion factor(reimbursing price level) of the oriental medical services, based on health insurance claims data and macro economic data. Methods : Comparing cost accounting method, SGR model, and index model to estimate conversion factor in the national health insurance, six empirical models were derived depending on the scope of revenue considered in financial indicators. Classifications of data and sources used in the analysis were identified as officially released by the government. Results and Conclusion : Cost accounting analysis and SGR model showed a two digit decrease in the physician fee schedule of oriental medical services in the national health insurance, while index model indicated a positive increase in the fee reimbursed. As expected, SGR model measured an overall trend of health expenditures rather than an individual financial status of medical institutions, and index model properly estimated the level of payments to oriental medical doctors. Upon a declining share of health expenditures on oriental medicine, a global budget system fixed to a flat rate of total budget could be an opportunity as well as a challenge.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.3 no.3
• /
• pp.221-226
• /
• 2002

The SGR system which is the basis for setting Medicare conversion factor updates was enacted since 1992. The SGR sets a target rate of spending growth based on factors influencing medical costs. In our situation of Fee Contracts in Korea, there exist much conflicts with SGR. This article seeks how we can implement the SGR system successfully in Korea. The major points are estimation of real economic parameters, adjustment of prior estimation, consideration of important factors influencing medical costs.

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