• Title/Summary/Keyword: medical fee

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The Calculation of Geographic Practice Cost Index and the Feasibility of Using It in Korean Payment System (진료비용 지역보정지수의 산출 및 국내 적용의 타당성)

  • Kim, Hansang;Chung, Seol Hee
    • Health Policy and Management
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    • v.29 no.2
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    • pp.130-137
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    • 2019
  • The fee-for-service system is used as the main payment system for health care providers in Korea. It has been argued that it can't reflect differences in the medical practice costs across regions because the fee schedule is calculated based on the average cost. So, some researchers and providers have disputed that there is need for adopting geographic practice cost index (GPCI) used in the United States for the Medicare program for the elderly to the fee-for-service payment system. This study performed to identify whether the difference in the practice costs among regions exists or not and to examine the feasibility of applying GPCI to Korea payment system. For this purpose, we calculated modified-GPCI and examined considerations to introduce GPCI in Korea. First we identified available data to calculate GPCI. Second, we made applicable GPCI equations to Korea payment system and computed it based on four types of regions (metropolitan, urban, suburban, and rural). We also categorize the regions based on the availability of the medical resources and the capability of utilizing them. As a result, we found that there wasn't any significant difference in the GPCI by regional types in general, but the indices of rural areas (0.91-0.98) was relatively low compared to the indices of other regions (0.96-1.07). Considering the need to use GPCI floor, the pros and cons of using GPCI, and the concern of the regional imbalance of resources, the introduction of GPCI needs to be carefully considered.

The Selection of the Medical Institutions by Motivation of Medical Service Utilization (의료이용 동기에 따른 의료기관 선택요인)

  • Kim, Jeong-Yeon
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.217-230
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    • 2015
  • This study investigated the differences in how medical institutions are chosen according to the motivation of medical service utilization(minor disease, major disease, chronic disease management, cosmetic). Importance order of selection for the minor disease were medical skill, kindness, rapidness, proximity, importance order of selection for major disease and cosmetic were medical skill, facilities, reputation, medical fee, importance order of selection for chronic disease management were medical skill, facilities, kindness, medical fee. From this medical study skill was a more important factor in medical institutions irrespective of motivation, subjects with the major disease tend to consider the selection of the medical institutions more important, except proximity. Medical users select medical institutions according to the motivation of visiting, and there were differences in same motivation according to socioeconomic status and information searching behavior.

A Study on the Variation in Meical Service Utilization of The Dead by Cerebrovascular Diseases Patients in Korea (뇌혈관질환 사망자 의료이용 변이의 분석)

  • Hong, Worl-Lan;Jung, Doo-Chae
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.36-61
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    • 2009
  • This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

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Variation of the Medical Service Utilization of the Dead by Cancers (암 사망자의 의료이용 변이)

  • Hong, Worl-Lan;Lee, Won-Jae;Youn, Kyung-Il
    • Korea Journal of Hospital Management
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    • v.12 no.3
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    • pp.1-19
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    • 2007
  • This study focused on finding the variation of medical service utilization and medical payments of the patients died by three, cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of slays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, were matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follow. The variation of medical service utilization of the dead by cancers were not small in Korea. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that tile factors of suppliers and utilizers should he reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could he recommended to reduce the high variation of medical service Use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.

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The Success requirement of implementing Medicare's SGR in Korea (Medicare의 SGR을 우리나라에 도입하기 위한 전제)

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

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A Problem of Disqualified Fee Imposition Standard in Public Cremation Facilities on Internet Reservation of e-Haneul Funeral Total Information System and an Improvement Proposal (공설화장시설 사용료 부과기준 부적정이 e-하늘 장사종합정보시스템 인터넷 예약에 미치는 문제점 및 개선방안)

  • Choi, Jae-sil;Kim, Jeong-lae
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.16 no.3
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    • pp.163-172
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    • 2016
  • This study conducts an analysis of a problem on internet reservation of e-haneul funeral total information system by disqualified fee imposition standard in public cremation facilities through research and investigation focusing on the operational realities and an ordinance related to public cremation facilities made by each local government across the country, and then is to suggest a policy proposal to improve the drawn problem. As a result of the analysis, as a way to improve the drawn problems, this study suggests a policy proposal that prevents an illegal camouflaged move-in to reduce fee by restricting residence period in requirement of local residents inside the jurisdiction who can use public cremation facilities, raises fee of public cremation facilities of local residents inside the jurisdiction into the optimum level that is set cheaper than production cost, and unifies age norm of an object to apply adult fee in the central government about a difference of age norm of an object to apply fee of adult with the highest availability of public cremation facilities between local governments, resolving a fee difference through fee cutting of local residents outside the jurisdiction priced higher than production cost.

A Study of Attitudes to Changed Health Care Delivery System in a Community (보건의료제도 변화에 대한 지역주민의 수용태도 분석)

  • Yu, Seung-Hum;Sohn, Myong-Sei;Park, Jong-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.162-168
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    • 1989
  • This study was conducted to analyse attitudes to a new health care system in a rural community. The specific purpose of this thesis was to classify attitudes to the patient referral system in Kangwha county, and to identify factors affecting the attitudes. Sampling was done by a multi-stage stratified cluster sampling method from the population. The data were collected in Kangwha county through a structured interview survey for two weeks in June, 1957. Attitudes to the patient referral system were classified into four types based upon answers to questions about awareness of the system, the recognition for the necessity of the system, and opinions on the improvement of the system. The four types of attitudes were active acceptance(10.2%), partial acceptance (27.2%), refusal(35.8%), and indifference(26.7%). The respondent's age, educational level, age of head of household, medical insurance fee, the number of ill family members, and the percentage of medical utilization by the family were the variables which affected the attitudes. The medical insurance fee, respondent's age, age of head of household, and the percentage of medical utilization by the family were the statistically significant discriminant factors of the four types of attitudes.

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Investigation of the Current Clinical Result of Korean Medical Treatment of Infertility -In Major University Korean Medicine Hospitals and Local Korean Medicine Clinics Participated in the Research- (한방 난임 치료의 특성과 결과에 대한 분석 -2011년 주요 한의과대학 부속한방병원 및 연구 참여 한의원을 중심으로-)

  • Lee, Dong-Nyung;Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.69-87
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    • 2014
  • Objectives: We analyzed retrospective clinical data of Korean medical institutes for infertility care and investigated current status and outcome of the Korean medical treatment of infertility as a part of foundational research for verifying validity of constructing national support system and developing appropriate policy on Korean medical treatment of infertility. Methods: We investigated data uploaded on the homepage of The Society of Korean Medicine for Subfertility (http://www.okinfertility.org) by Korean medical institutes for infertility care to get informations such as patients' age, body height, weight, methods of Korean medical treatment, cost and duration of treatment, success or failure of pregnancy and result of treatment. Results: The average age of patients was $33.1{\pm}3.8$ and the average body height was $161.2{\pm}5.3cm$ and the average body weight was $55.2{\pm}8.5kg$. The method of Korean medical treatment was Herbal medicine (97.5%), acupuncture (80.4%), moxibustion (57.7%), cupping (32.7%). The average cost of treatment was $1,160,625{\pm}882,499$ won, and the average medical cost per visit was $357,845{\pm}241,602$ won. The average duration of treatment was $11.26{\pm}10.58$ weeks, and the average number of visits per patient was $4.78{\pm}6.10$ times. The average duration of treatment was the longest in the group of infertile patients with the highest average medical cost per visit. The average pregnancy success rate was 30.9% overall, and that of the group of infertile patients was 25.8%. Conclusions: When we develop the standard project model with expectation for about 25% success rate of pregnancy and delivery in the group of patients who have idiopathic and ovulatory factors, it is desirable to perform acupuncture and moxibustion treatment 1-2 times a week with herbal medicine. The treatment period is set to at least 12 weeks. Average treatment fee maybe calculated by converting the averaged treatment cost of clinic's one month worth of daily treatment fee and medical hospital's ten day treatment fee into weekly treatment cost.