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

검색결과 381건 처리시간 0.023초

CM 대가 산정방식의 문제점 분석에 대한 연구 -문화예술회관 사례를 중심으로- (Diagnostic Analysis and Influential Factors of CM Fee Estimation)

  • 유병기;정찬영;김재준
    • 한국건설관리학회논문집
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    • 제7권6호
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    • pp.132-140
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    • 2006
  • 1996년 12월 정부에서는 국내 건설산업의 효율성을 높이기 위하여 건설사업관리(CM) 제도를 처음 도입하게 되었다. 그러나, CM의 필요성을 인식하면서도 건설사업 초기단계에서 예상되는 문제점 및 낭비요소의 최소화와 객관적인 기술검토 등을 통한 의사결정능력은 향상되었지만, 발주자의 선택권이 보장되는 다양한 CM 서비스체계 구축과 CM대가 산정에는 많은 문제점이 존재한다. 정부가 발주하는 공공건설사업의 경우 발주자가 산정하는 방식과 CM업체가 산정하는 방식의 차이로 인해서 적정대가를 받지 못해 CM대가 산정이 제대로 이루어지지 않는다. 따라서, 본 논문에서는 실제 공공건설사업 중에서 문화예술회관 사례를 토대로 CM대가 산정에 대해 공사비비율에 의한 방식, 실비정액가산방식의 실제 계약된 금액을 다각도로 분석하여 어떤 불합리성이 존재하며, 아울러 그 원인은 무엇인지에 대해 분석하고자 한다. 이를 토대로 향후 CM의 적정대가 산정기준을 위한 연구의 자료에 일조를 하고자 한다.

뇌혈관질환 환자군의 가정간호 행위묶음 수가연구 (Estimation of Home Care Nursing Cost to the Patient with Cerebrovascular Disease based on a Bundle of Home Care Nursing Service)

  • 홍진의;윤순녕
    • 가정간호학회지
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    • 제7권1호
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    • pp.26-38
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    • 2000
  • The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

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사용자 잠재선호특성을 고려한 스마트 주차서비스 설계요건 연구 (A Study on Design Requirements for Smart Parking Services Considering User'S Stated Preferences)

  • 장정아;이현미;이원우;김현미;김태형
    • 한국전자통신학회논문지
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    • 제16권6호
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    • pp.1279-1286
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    • 2021
  • 본 연구는 주차장 검색 및 사전예약서비스가 가능한 스마트 주차서비스에 대한 것으로, 요금(예약요금, 위약금) 등과 관련된 사용자의 선호선택 모형에 관한 연구이다. 스마트 주차서비스에 대한 응답설문을 구성하여 로짓 모형형태의 사용자 선호도 모형을 두 가지를 구축하였다. 첫 번째는 스마트주차장을 선택하는 모형으로 이용요금과 비용과의 관계에서 일반 주차장보다 선택확률이 높아지는 상황을 제시하였다. 두 번째는 주차권 예약할인 선택모형으로 예약금액과 위약금과의 관계 모형을 통하여 스마트주차서비스 선택확률을 분석하였다. 사용자의 선호도를 고려한 정교하고 다양한 형태의 스마트 주차서비스가 가능한 설계 요구사항으로 활용이 가능할 것으로 판단된다.

완화의료 일당정액수가제 시행에 따른 진료비와 진료행태의 변화 (Changes in the Medical Cost and Practice Pattern according to the Implementation of per Diem Payment in Hospice Palliative Care)

  • 임문남;최성우;류소연;한미아
    • 보건행정학회지
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    • 제29권1호
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    • pp.40-48
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    • 2019
  • Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

Service Scheduling in Cloud Computing based on Queuing Game Model

  • Lin, Fuhong;Zhou, Xianwei;Huang, Daochao;Song, Wei;Han, Dongsheng
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제8권5호
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    • pp.1554-1566
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    • 2014
  • Cloud Computing allows application providers seamlessly scaling their services and enables users scaling their usage according to their needs. In this paper, using queuing game model, we present service scheduling schemes which are used in software as a service (SaaS). The object is maximizing the Cloud Computing platform's (CCP's) payoff via controlling the service requests whether to join or balk, and controlling the value of CCP's admission fee. Firstly, we treat the CCP as one virtual machine (VM) and analyze the optimal queue length with a fixed admission fee distribution. If the position number of a new service request is bigger than the optimal queue length, it balks. Otherwise, it joins in. Under this scheme, the CCP's payoff can be maximized. Secondly, we extend this achievement to the multiple VMs situation. A big difference between single VM and multiple VMs is that the latter one needs to decide which VM the service requests turn to for service. We use a corresponding algorithm solve it. Simulation results demonstrate the good performance of our schemes.

일본 노인주거시설의 종류와 공급특성에 관한 연구 (A Study on the Types and Supply of Elderly Housing in Japan)

  • 권순정
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제16권3호
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    • pp.49-56
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    • 2010
  • In Japan, a lot of elderly housing types have been developed in order to meet various needs of the older person and the change of social situations. Elderly housings can be divided into three categories elderly housings for healthy older persons, elderly care homes for the healthy and elderly care facilities for the unhealthy. Elderly housings include public and private rental housings. Sometimes they can be designated only for the elderly. Elderly care homes for the healthy elderly include full fee charging elderly housing, elderly homes, low fee charging elderly homes and care houses. Elderly care facilities for the unhealthy elderly consist of full fee charging elderly care homes, group homes for the dementia, elderly health facilities, nursing homes, elderly hospitals, and so on. However "elderly care facilities" have been proved not to be efficient for the delivery of elderly welfare services nor satisfactory to the frail older person. Therefore, based on the concept of the "Normalization", daily services have been provided for the elderly in order that they can live at their own home in the community for themselves. As a result, Japan aims not only to reduce elderly welfare expenses but also to increase elderly users' satisfaction. Emphasis on non-institutionalization and in-home services, regional characterization, harmony between Hard and Soft, user oriented services, substantiality, universal design and so on are sought for the sake of those goals.

지속가능한 건설사업관리를 위한 발전방안 (Suggestions for Sustainable Construction Project Management)

  • 이승훈
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2021년도 가을 학술논문 발표대회
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    • pp.240-241
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    • 2021
  • For the sustainable development of the domestic construction project management field, each CM company should try to diversify in terms of service contract types and scope of work while having internationally competitive technical and service capabilities as follows. First, from the initiation of the service to the completion, the CMr should be able to establish and execute a plan to create specific outcomes. Second, CMr must have the capability to produce weekly or monthly cost, schedule, risk, and scope management reports. In addition, it should be possible to apply the cost plus sliding fee method or to systematically and continuously accumulate and process data generated during the construction process.

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수술수가의 적정성에 관한 연구 - 상대가격체계와 항목분류를 중심으로 - (A Study on the Propriety of the Medical Insurance Fee Schedule of Surgical Operations - In Regard to the Relative Price System and the Classification of the Price Unit of Insurance Fee Schedule -)

  • 오진주
    • 한국보건간호학회지
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    • 제2권2호
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    • pp.21-44
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    • 1988
  • In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

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병원 약제행위의 원가구조 및 수가체계 개선방향 (Cost Structure of the Hospital Drug Services and Their Directions for Price System Improvement)

  • 황인경;이의경;이진이;장선미
    • 한국병원경영학회지
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    • 제5권1호
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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.

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응급전문간호행위에 대한 건강보험 상대가치 수가개발 및 경제성 평가 (Economic Analysis and Fee Development by Relative Value Scale of Nursing Practices by Emergency Nurse Practitioner)

  • 김진현;김경숙;김미원;이경아
    • 성인간호학회지
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    • 제25권3호
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    • pp.275-288
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    • 2013
  • Purpose: The purpose of this study was to perform an economic analysis and estimate the fee for the practices that carried out by Emergency Nurse Practitioner (ENP) using relative value scale (RVS) and its conversion factor. Methods: First, we developed ENP's RVS for 25 advanced nursing services based on ENP's workload and its time spent by survey. A cost analysis was performed to evaluate the conversion factor of ENP's RVS. The share of ENP's contribution to fee-for-service in emergency setting was also analyzed. Results: Calculation of the RVS of 25 advanced nursing practices showed a range of points from 73.4 to 296.3 and an average of 145.1 points. The relevant conversion factor for advanced nursing practices among ENP was estimated at 12.2~15.9 won. The contribution rate of ENP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 13.1~17.0%. Conclusion: The practices of ENP are not compensated separately and its reimbursement is usually included in physician fee. An estimation of nursing fee and an independent fee related to ENP's services shows the contribution rate to total revenue. It suggests that emergency nurse practitioners be considered as a revenue source the in emergency room.