• 가정간호학회지
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• 제2권
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• 한국융합학회논문지
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• 제8권12호
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• pp.391-395
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• 2017

본 연구에서는 안경 조제 가공료와 피팅비 필요성 및 정착화에 필요한 내용에 대한 설문조사를 실시하였다. 2016년 8월 1일부터 9월 30일까지 서울, 경기 지역의 안경사 202명을 대상으로 각 설문항목을 설정하고 온라인 오프라인으로 설문조사를 실시하였다. 모든 자료의 통계처리는 Origin Pro 8.5를 사용하여 실시하였다. 안경 조제 가공료와 피팅비 도입의 필요성에 대하여서는 각각 92.1%(186명), 93.1%(188명)가 도입 필요성에 대해서 긍정적으로 평가하고 있었다. 안경 조제 가공료와 피팅비에 대한 설문분석 및 해외사례를 통해 안정화된 정책을 제공함으로써 보건의료 서비스 전문가로서 안경사의 위치를 정립하여야 할 필요가 있다고 조사되었다.

• 한국건설관리학회논문집
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• 제16권3호
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• pp.152-164
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• 2015

건설기술용역 대가기준이 명확하고 투명해지면, 발주자와 입찰자 입장에서는 용역 투입비용에 대해 예측 및 정산이 가능하며, 실제 업무를 수행하는 엔지니어 입장에서도 실질적인 혜택이 돌아갈 수 있게 된다. 최근 정부는 건설기술용역 국제경쟁력 향상을 위해 그간 사업의 규모와 상관없이 사용해오던 공사비요율방식에 의한 대가산정방식의 사용은 지양하고 점차 실비정액가산 방식으로 개선하고 있다. 그런데 개정된 실비정액가산방식의 대가산정기준을 적용하였을 경우, 기존 방식에 비하여 153%~197% 용역비가 상승하기 때문에, 개정된 대가산정기준 적용에 논란이 없으려면 기존 정산방식이나 정산근거에 대한 검토가 필요하다. 이를 위하여 미국, 영국을 비롯한 해외 사례와의 비교 분석을 통하여 2014년 개정된 건설기술용역 대가기준을 분석하였다. 분석결과, 큰 틀에서는 선진국과 같이 실비정액가산방식으로 원가계산방식을 일원화한 것은 매우 중요한 변화이지만, 상세내역계산에서는 해외와 달리 산정방식이 복잡하고, 직접인건비에 일부 간접경비가 포함되어 있으며, 제경비 기술료 등 간접경비를 포괄적으로 인정하여, 경비의 중복산정 문제나 집행내역의 불투명성 문제가 여전히 존재하는 것으로 나타났다. 이에 대한 여러 해결방안을 제안하였다.

• 보건행정학회지
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• 제7권2호
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• pp.65-88
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• 1997

In Korea, telemedicine is still under the beginning stage, but we expect that the developing 'Information Highway' will make this technology more common place and more easily used in coming soon. Currently, three hospitals are providing telemedicine services with their subsidiary hospitals which are far away from their remote place. However, the fee schedule of telemedicine services are not well-settled down, of course not reimbursed through current health insurance system. This study aims to develop new payment system for medical services provided through telemedicaine system. To design appropriate fee schedule for telemedicine services, we, first, review the current insurance payment system and telemedicine system both in domestic and foreign countries focusing on its payment system. A framework of telemedicine payment system is proposed in following steps based on information we acquired from this stage. Second. We decide the span of cost items which should be covered by telemedicine payment scheme. In hear, we suggest payment method for telemedicine services should be designed as dual structure which are telemedicine fee that should be reimbursed through payment scheme and any costs related to capital investment that should not be covered by payment system. Which is, payment system for telemedicine services should cover only service-related costs and any costs related to capital investment should be generated through third party such as government, health insurance association, etc. Finally, we suggest new fee schedules for telemedicine services. The key issues on developing telemedicine fee schedules are related with the determination of appropriate additional rate($\alpha$). The reasonable additional rate($\alpha$) must determine through careful evaluation of any additional efforts(e. g. : additional work hours which are related to providing telemedicine services). This study shows the process of how to determine appropriate additional rate($\alpha$).

• Korean Journal of Acupuncture
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• 제24권3호
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• pp.67-79
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• 2007

Objectives : The Purposes of this study were to investigate payment system for oriental medical treatment as supplier of medical services, and to estimate reasonable levels of medical fee. Methods : This study made these following results by reviewing the answers which were given by 172 Korea traditional doctors from March 1 to April 15, 2006. Results : General satisfaction of payment system for oriental health insurance was $2.17{\pm}1.01$ $(mean{\pm}SD)$ on a 1-7 scale (median 4) as very low level. Reasonable medical fees which were answered by 172 Korea traditional doctor are higher than present fees, thus Korea traditional doctors think that present fees should be increased. And according to the survey, current insurance fees have a problem of disparity between each treatment fee. Conclusions : According to results of this study, current fees of oriental medical treatment are not rational. And this problem leads to distortion of medical treatment. Additional studies in thls field are needed.

• 인터넷정보학회논문지
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• 제9권3호
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• pp.119-128
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• 2008

상용의 소프트웨어를 사용하기 위해서 대부분의 소프트웨어 사용자는 그 소프트웨어를 구입하여야한다. 하지만 해당 소프트웨어에 대한 사용 시간이 길지 않은 경우, 그 소프트웨어 비용은 과다한 지출로 인식된다. 소프트웨어 임대 서비스는 이러한 경우 효과적인 대안일 수 있다. 소프트웨어 임대를 지원하기 위해서는 요금 부과 기법이 필요하다. 두 종류의 요금 부과 기법이 생각될 수 있다. 하나는 특정 기간 소프트웨어 사용에 대하여 일정한 요금을 부과하는 것이며 다른 하나는 실제 사용한 시간에 따라 요금을 부과하는 것이다. 이 논문에서는 소프트웨어의 실제 사용 시간에 따라 요금을 부과하는 기법을 제안한다 소프트웨어의 실제 사용 시간에 따라 요금을 부과하기 위하여 사용 시간을 정화하게 측정할 수 있는 기법을 고안하였다.

• 한국병원경영학회지
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• 제8권4호
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• pp.149-181
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• 2003

It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

• 전자통신동향분석
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• 제36권4호
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• pp.81-91
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• 2021

Recently, discussions on Metaverse, which represents the transcendent world, have been dominant for some time. Cases related to the Metaverse are introduced through various media and are continuously attracting attention as the next generation of the Internet. This study reviews the business model and the ecosystem overview, focusing on service cases related to the Metaverse. The widely used business models include content production and sales, media brokerage fee, and marketing fee. The Metaverse ecosystem is formed around games, with major players in game production, authoring tool & support SW, intelligent cloud service, and game platform expected to lead the market. Results show that a strategy to secure the leadership of the Metaverse, such as the business model expansion conditions, a strategy to foster a game-oriented Metaverse ecosystem, and technology development for the realization of the ultra-realistic Metaverse, is necessary.

• 대한치과의사협회지
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• 제48권1호
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• pp.6-11
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• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.309-316
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• 2014

Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.