• Title/Summary/Keyword: fee-for-service

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Stakeholder Survey on the Incentive Program to Promote the Adoption of Health Information Exchange (진료정보교류 인센티브사업에 대한 이해관계자 조사연구)

  • Park, Hayoung;Ock, Minsu;Park, Jong Son;Lee, Hye Rin;Kim, Soomin;Lee, Sang-il
    • Journal of Information Technology Services
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    • v.16 no.3
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    • pp.17-45
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    • 2017
  • Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

Research on John School as a policy to prevent recidivism of online sex trafficking

  • Park, Jong-Ryeol;Noe, Sang-Ouk
    • Journal of the Korea Society of Computer and Information
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    • v.23 no.8
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    • pp.143-149
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    • 2018
  • Recently, President Donald Trump signed FOSTA (Fight Online Sex Trafficking Act) in April 11, 2018, which makes online service no more immune from civil liability for the action of third party facilitating sex trafficking content. Although it is also important to enhance security regulations and cognition on law, but it will be economically more effective to put more energy on preventing recidivism. For John School in Korea, it should increase implementation rate by putting core manpower and budget for preventing needs of sex purchase and then, check operation method and efficacy to improve the actual program. One way is first, empirical analysis and data is required on efficacy of John School program. Second, should have clear definition in Special Sex Trade Law. Third, more strick regulation for selecting participant is required. Fourth, more manpower and budget is required. Fifth, charging the participant for educational fee shall be reviewed. Sixth, educational program should be reviewed. The most important point of education is to make those criminals feel guilty about financially purchasing the sex, basically making them to recognize that it is ethically wrong. However, the current education system contains no clear explanation about the ethical issue of such problem but focusing more on other factors such as sexual disease and structural problem of sexual business. Therefore, this failed to deliver the right psychological training to those criminals without any ethical control. Knowing why women feel hurt when having unwanted sexual relationship by being paid is required part in terms of education for preventing sex trafficking.

Dental hygienists' perspective and coping measures towards medical market opening (의료시장 개방에 대한 치과위생사의 인식과 대응방안)

  • Jung, Gi-Ok;Kim, Ho-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.3
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    • pp.503-511
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    • 2012
  • Objectives : This research seeks to present the data needed for the development of coping strategy, following medical market opening by identifying dental hygienists' perspective and coping measures towards the opening. Methods : One hundred eighty-eight dental hygienists were targeted to identify their level of perception towards medical market opening, attitude towards medical market opening, question of whether they agree or not with the opening and reasons, and coping measures and benefits of the medical market opening. t-test, chi-square test and cross-tabulation analysis were used for the analysis Results : First, team leaders are more aware of the medical market opening and hold greater sense of crisis towards opening compared to the rank and file. Second, the reasons cited for agreeing with the medical market opening included improvement of medical services' quality and diversification of services. As for the reasons for disagreeing, they cited the increase medical expenses paid by public. Third, limitation of the hospital management technique was cited the most when it comes to the scope of Korean hospitals' management crisis, followed by the limitations of the diagnosis procedure, limitations of the medical services, limitations of the medical techniques and increase in the number of large hospitals, in the order cited. Fourth, team leaders perceive greater need to seek coping measures from the aspect of realizing medical insurance fee from the policy development, service and system level aspects when it comes to the coping measures depending on their ranks. Conclusions : Therefore, Dental Hygienist has a comparatively low awareness of medical market opening, coping measures need to be explored to cope with the medical market opening by ensuring the dissemination of accurate knowledge through the education on the fees for dental hygienist and seminars in relation to the medical market opening.

A Study of Hospital Foodservice Satisfaction after Covering Hospital Foodservice in the National Health Insurance (병원 급식 식대 급여화에 따른 입원 환자의 급식만족도 조사)

  • Hwang, Rah-Il;Kwon, Jin-Hee
    • Korean Journal of Community Nutrition
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    • v.13 no.3
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    • pp.396-404
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    • 2008
  • This study aimed to evaluate the amount of patients' satisfaction with hospital foodservices among those who were benefited from national health insurance during their hospitalization. A total of 3,094 inpatients from 191 medical institutions were enrolled in this survey. The survey was carried out from July 23 to September 14, 2007 through the face-to-face interview method. All analyses were made using the SPSS software (version 13.0). The mean age of the participants was 53.3 years, 57.0% were women; 34.7% were high-school graduates. Among the respondents, 30.9% stayed in the hospital for $7{\sim}14$ days long, and 52.0% were hospitalized in multi-patient rooms for six persons. The 87.7% of total population had a general diet, and 9.6% selected the food menu that was notcovered by health insurance. In addition, 38.3% of patients regarded the fee of foodservice as inexpensive. Overall, the satisfaction score with hospital foodservice was 3.63 on a Likert-type scale ranging from 1 (extremely dissatisfied) to 5 (extremely satisfied). However, the limitations were indicated including the lack of providing nutritional information and quality of taste. In conclusion, the quality of hospital foodservice might not deteriorate even after enforcement of national payment of medical insurance. Further efforts are required for the diversification of menus and legislative work for improving quality of food service for a successful hospital foodservice policy.

The Factors for Food Service Satisfaction of the Elderly Welfare Center Free Lunch Program Participants in Busan (부산 일부지역 복지관 무료급식 이용노인들의 급식만족도에 영향을 미치는 요인)

  • Lee, Jeong-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.1
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    • pp.128-136
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    • 2011
  • This study was carried out to investigate the factors of food service satisfaction of the elderly in Busan. The survey was conducted from September 1 to October 15, 2009 by questionnaires and data analyzed by SPSS program. Fifty point nine percent of the subjects lived alone and the source of living expenses of 70.5% of the subjects was subsidy from government. The most important reason for the elderly to participate in meal service was 'economic difficulty' and 'to meet friend'. The subjects had various chronic degenerative diseases, such as arthritis, hypertension, diabetes, osteoporosis and cardiac disease. Sixty-six point eight percent of the subjects needed diet therapy for their diseases, but 87.1% of them don't want to pay the extra fee. Thirty six point five percent of the subjects attained information about lunch program because it was 'close to home' but 20.7% was 'from public officials'. The reasons for the use of the meal service were 'economic difficulty' (40.0%), 'to meet friends' (22.6%), and 'bother to prepare meal' (16.50%). The services provided by welfare center were health care, physical exam and haircut. The score given by the subjects on the satisfaction of meal service was 3.84 on the 5-point maximum scale. Higher satisfaction on kindness of staff, satisfaction of social support and awareness of support resulted in higher satisfaction of food service. It would be effective to provide food service models that meet specific needs of the elderly according to social welfare service and social community activities.

The U.S. Experience of the DRG Payment System and Suggestions to Korea (DRG 지불제도에 대한 미국의 경험과 우리 나라에의 시사점)

  • Park, Eun-Cheol;Lee, Sun-Hee;Lee, Sang-Gyu
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.105-120
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    • 2002
  • In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

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Survey on the Needs of Korean Medicine Doctor for Community Care Education Programs (한의약 건강돌봄 교육 프로그램에 대한 한의사 요구도 조사)

  • Jihye Kang;Eunji Ahn;Jihyeon Lee;Dongmin Sung;Yujin Han;Dongsu Kim
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.1-11
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    • 2024
  • Objectives : This study conducted a survey on the needs of Korean medicine doctors for health care education programs specializing in traditional Korean medicine. Methods : The study selected Korean medicine doctors who had experience participating in outpatient consultations. Data collected through surveys underwent frequency analysis on performance, importance, difficulty, and educational needs using SPSS 24.0. Additionally, an Importance-Performance Analysis (IPA) was conducted using importance and performance data. Results : According to the results of the IPA analysis, in the area of "keep up the good work" there were activities such as fee Claims (A3), comprehensive assessment (B4), care plan development (B5), client and caregiver interviews (C8), chronic disease monitoring (C9), musculoskeletal and other pain management, musculoskeletal rehabilitation (C10), mental health management (C11), and fall prevention (C15). In the "concentrate here" priority action area, skin care including pressure sore management (C13) was identified. Conclusions : The traditional Korean medicine community care service is expected to expand further, so it is anticipated that the developed educational programs will contribute to the activation of traditional Korean medicine health care business.

Optimal Nursing Workforce and Financial Cost to Provide Comprehensive Nursing Service in the National Health Insurance System (국민건강보험 간호·간병통합서비스의 전면 도입을 위한 간호인력 및 재정비용 추계)

  • Kim, Jinhyun;Kim, Sung-jae;Lee, Eunhee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.119-128
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    • 2017
  • This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.

Preferences Factors Analysis for Car-sharing (카쉐어링의 선호 요인 분석연구)

  • Kim, SukHee;Lee, Kyujin;Choi, Keechoo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.34 no.4
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    • pp.1241-1249
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    • 2014
  • This study presents preferences factors analysis of Car-sharing in Suwon. Approximately, 60% of the citizens prefer car-sharing and consider using it. The results of analysis by factors show higher preferences in these groups of travelers: man, younger, a resident of detached house and efficiency apartment, user of public transportation who finds it uncomfortable, traveler without vehicles, and traveler using car 1 to 3 times a week. The potential demand for car-sharing was highest in the residential areas and around the stations. Travelers prefer to pay the fee by the hour, which the fair value was 7,967 won. For the trip purpose of business, shopping and leisures, car-sharing is more preferred than taxi and rental cars. Findings will contribute to determining the direction of policy for the car-sharing.

Development of efficiency indicators for medical resources use using Delphi technique (델파이 조사법을 이용한 의료 자원 사용의 효율성 평가지표 개발)

  • Choi, Yoon-Jung;Kwon, Young-Dae;Kim, Chang-Soo;Kim, Yoon
    • Health Policy and Management
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    • v.22 no.1
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    • pp.65-84
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    • 2012
  • Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.