• 한국병원경영학회지
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• 제19권1호
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• pp.32-42
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• 2014

It is necessary to calculate prime cost of medical services accurately in order to evaluate the adequacy of medical fee. This paper aims to identify cost analysts' perception on prime cost of medical services and needs in establishing a cost accounting system in hospitals, proposing future directions and guidelines for the calculation of medical fee. A self-administered questionnaire and telephone survey on operation of a hospital cost-accounting system was conducted in November, 2012, among cost analysts currently working in the hospitals and hospital administrators planning to implement the hospital cost-accounting system. Our study shows that most of the cost analysts were aware of the importance of calculating prime cost and responded that collection of the prime cost data from government is necessary although they are less likely to provide the data in the future concerning the risk of data misuse and data security. They also responded that lack of budget allocation and excessive workload were the main reasons for not estimating the prime cost and operating cost management information system. Results show that hospital cost analysts considered the data accuracy is the most critical factor in calculating prime costs of medical services. However, there was no investment budget allocated in some hospitals or limited to less than 100 million, indicating that hospitals are reluctant to invest on implementing the cost accounting system. Respondents stated the organization that collects the prime cost of medical services among hospitals should display strong analytical capabilities, ensure data security, and maintain independence, which is most demanded. There are 57 hospitals that calculated the prime cost of medical services for 2012 by each medical department and 20 hospitals that calculated the prime cost by fee-for-services, aiming to establish a cost accounting system. Our results indicate that hospitals should voluntarily provide the accurate prime cost for medical services in order to properly evaluate the adequacy of medical fee. Consequently, it is critical to establish an independent organization to collect and appraise the data. It is also recommended that government should implement various policies to encourage hospitals to participate in the data collection to achieve the data accuracy and representativeness.

• 보건행정학회지
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• 제20권2호
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• pp.40-52
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• 2010

Health insurance fees are set by relative value scales and conversion factors. Since 2008 the conversion factor has been classified into 7 according to the provider type, and a separate contract has been made respectively. As such classification of the conversion factor reflects only the different characteristics of providers, however, further classification to reflect the different cost structures of providers is proposed. Cost varies according to the type of not only providers but also services each provider supply. In fact different cost structures of providers are the result of their different services. This study analyzed the cost structure of medical services to propose a new approach to the classification of the conversion factor. This study analyzed the cost structure of medical services using cost data constructed in the revision study of relative value scales. The cost data consist of doctor's fee, support staff's fee, cost of medical equipments, cost of medical supplies and indirect cost. The proportion of each cost component to the total cost was analyzed in terms of service department and service type. 72 service groups are defined in terms of the combination of service department and service type. Through cluster analysis, 72 service groups were reduced into 7 clusters each of which has a similar cost structure. Conversion factor is contracted annually to reflect the change in the cost of providing medical services. So the classification of conversion factor has to be based on the cost structures of medical services, not the characteristics of providers. Service clusters derived in this study can be used as a new classification for health insurance fee contract.

• 의료법학
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• 제13권2호
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• pp.11-38
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• 2012

The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

• 대한치과기공학회지
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• 제39권2호
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• pp.119-128
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• 2017

Purpose: In order to increase competitiveness for the growth and development of the dental laboratory industry, we plan to develop the dental laboratory industry. Methods: A total of 547 questionnaires were used as the final analysis data for the dental technicians from all over country participated in the 51st Korea Dental Technology Expo & Scientific Conference of the Korean Dental Technologist Association held in KINTEX from July 18 to 19, 2015. The questionnaire items consisted of 28 items in terms of general characteristics, questions about the methods to be pursued for the development of the dental laboratory industry, and recognition about the methods to be pursued to develop the dental laboratory industry. The collected data were analyzed by SPSS Ver. 21.0 for windows. Results: To improve the dental laboratory industry, actualization of dental laboratory products fee(41.2%) had the highest, followed by improving treatment of dental technician, standardization of dental laboratory products, direct bill of medical insurance, regulation of contract management on huge capital, and etc. The recognition of the measures to be pursued for the development of the dental laboratory industry was that dental laboratory products fee required to receive more than 20% of the dental prosthesis fee highest($4.62{\pm}0.76$). And to enlarge dental laboratories through M&A between dental laboratories is the lowest($3.39{\pm}1.26$). Conclusion: As a means to pursue the development of the dental laboratory industry, the actualization of dental laboratory products fee was proposed. Recognition also showed that dental laboratory products fee required to receive more than 20% of dental prosthesis fee was the highest. It is important to propose a reasonable dental laboratory products fee because it recognizes that it is necessary to promote economic growth in both development plan and awareness.

• 보건행정학회지
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• 제25권1호
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• pp.40-52
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• 2015

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.

• 대한한의학회지
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• 제35권4호
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• pp.65-73
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• 2014

Objectives: This study aimed to investigate the determinants of inpatients satisfaction and intent to revisit oriental medical hospitals. Methods: The independent variables of the study contain the level of satisfaction with doctors, nurses, staffs, medical fee, environment, facilities and hospital life. Each variable was measured by three to eight items about the level of satisfaction with various aspects of hospital ward life. The level of overall patient satisfaction was used as an intervening variable and the level of intent to revisit was used as a dependent variable. The sample used in this study consisted of 268 inpatients from 3 oriental medical hospitals located in Chungnam Province. Data were collected with a structured and self-administrated questionnaire and analysed using path analysis. Results: The major findings of the study were as follows : First, it was found that the 3 variables of hospital life satisfaction, ancillary staffs satisfaction, and metropolitan residents has significant positive effect on the level of overall patient satisfaction. Second, the overall satisfaction and the satisfactory level of facilities, medical fee, and quality of ward life were found to have significant effects on the level of intent to revisit of respondents. Conclusions: The results of the study indicate that oriental medical hospitals should make an effort to improve the overall satisfaction of inpatients, especially focusing on the facilities convenience, medical price, and hospital ward life which will lead to high level of intent to revisit of inpatients.

• 보건행정학회지
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• 제5권2호
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• pp.202-229
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• 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.

• 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.

• 건축사
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• 통권519호
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• pp.13-13
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• 2012

• Perspectives in Nursing Science
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• 제6권1호
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• pp.77-83
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• 2009

The number of nurses per bed at acute-stage hospitals is quite low in Korea compared with other OECD countries. In order to prevent the degradation of the quality of inpatient nursing services due to insufficient nurse staffs, the national health insurance introduced the differentiated nursing care fee system. This did not work as a motive for inducing the employment of nursing staff due to insufficient cost compensation. Because of insufficient nursing staff, family members have to stay with the patient or patients have to hire a personal care attendant. This increases the burden and cost to families. For the activation of hospitals without guardians, there should be policies for raising additional nursing staff such as standardizing jobs among nursing staff, particularly between nurses and nursing assistants, setting adequate standards of staffing in nursing according to medical service, substantiating the cost of nursing under the differentiated nursing care fee system, improving the medical fee system of hospitals without guardians including health insurance payment, supplying nursing staff stably through improving their working conditions such as providing child rearing services and salary increase, clarifying the qualification of personal care attendants working at acute.stage hospitals, developing indexes for assessing the quality of nursing care services, and monitoring for the management of uniform quality.