• 보건의료산업학회지
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• 제5권2호
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• pp.105-117
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• 2011

The purpose of this study is to investigate evaluation and improvement of long-term care hospitals for changing long-term care hospitals fee system. Data were collected from 104 CEOs in nationwide long-term care hospitals using structured self-administered questionnaires during August 17 to 31, 2009. Major results of the empirical analysis are as follows; first, to change fixed sum medical fee per day caused to decline the level of geriatric service in 87% of CEOs. Second, 79% of CEOs were dissatisfied with changing fixed sum medical fee per day, and 47% of them were dissatisfied with graded fee for doctor and nurse management. Finally, they suggested that to specialize and to differentiate of long-term care hospitals will drive to improve long-term care hospitals function and to measure workforce based on rate of filled vacancies will increase efficiency and productivity of doctor and nurse management.

• 보건행정학회지
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• 제31권4호
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• pp.399-408
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• 2021

The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.

• 한국시스템다이내믹스연구
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• 제6권2호
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• pp.53-71
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• 2005

In the short view, the medical fee regulation has contributed for patients by reducing their hospital expenses and helping them to visit hospital more easily. But, some medical parts have gone into red ink because the medical fee has been different with each item. So, that medical parts have been experienced the medical specialist shortage. And some hospitals have been interested in high-priced medical services to cover their deficit. Moreover, most medical doctors don't need to use low-priced medicine undergo these circumstance, domestic small and medium pharmaceutical company has been going into bankruptcy and the dependence on foreign drug company has been rising. If these abnormal medical service keep to patience, people will get more burden of medical fee cause 9 casual loop work very complicated. In other words, present medical fee regulation were made by some politicians who had plain thinking. Those who govern the people, therefore, stand for not present medical service user but the welfare and health promotion of people and give attention to desirable medical fee with systems thinking.

• 한국건설관리학회논문집
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• 제13권4호
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• pp.16-24
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• 2012

본 연구는 국내 외 건설사업관리 유사 건설기술용역 대가 기준 및 사례분석을 토대로 합리적인 건설사업관리 대가기준을 제안하는 것을 목적으로 한다. 이를 위해 기존의 건설사업관리 대가의 적정성을 분석하고, 사례분석을 통한 인력투입 실태를 조사하였으며, 비상주 인력의 적정수준에 대해 고찰하였다. 사례분석결과, 현행 건설사업관리 대가산정 체계는 책임감리와의 대가산정 방식의 이원화, 비 현실적인 대가기준 및 인력배치 등이 문제점으로 도출되었다. 이를 위한 개선 방안으로 건설용역 대가산정 방식의 정비, 건설사업관리 대가수준의 현실화, 사업초기단계 배치인력의 탄력성 확보, 사업특성을 고려한 비상주 인력 활용을 제안하였다. 본 연구는 향후 건설사업관리의 대가수준의 현실화 및 대가산정을 위한 접근방법의 개선에 기여하여 건설사업관리 업무의 효율성 향상에 도움이 될 것으로 기대된다.

• 대한간호학회지
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• 제23권1호
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• pp.68-89
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• 1993

This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6％ of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6％) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

• 보건행정학회지
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• 제29권2호
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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.

• 상하수도학회지
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• 제28권5호
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• pp.517-527
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• 2014

As sewer flooding frequents due to localized and concentrated stormwater and increased non-permeable surface area after urbanization, building cities with sound water recycle and accordingly efficient management of rainwater is demanded. To do this, the existing sewage (including rainwater) fee imposition system should be philosophically evaluated. This study presents problematic issues of the existing domestic sewage fee imposition system considering the principle of sharing costs on the service of sewage and rainwater collection and treatment. Four methods to improve the existing sewage fee imposition system are suggested: 1) imposing stormwater fee according to Polluter Pays Principle, 2) clarification of the share of public sector, 3) reducing or exempting the sewerage fee for inhabitants reducing urban runoff by constructing their own rainwater management facilities, 4) imposing charge for discharging rainwater to sewers due to new development action. Short, mid, or long term planning for rainwater management is recommended considering the situation of each municipality.

• 한국병원경영학회지
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• 제20권3호
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• pp.36-44
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• 2015

The Activity Based Costing(ABC) means the process that makes clear how the actions and input resources have changed into service to calculate medical services costs. These days, the number of hospital which is using the ABC system is increasing to make their policy decision making efficient and run the hospitals more resonable. This study analyzes the unbalance in the level of health insurance service fee and the improvement plans based from 8 hospitals(ABC system) and 95 clinics(ABC survey). The cost recovery ratio has shown different levels according to each service type. A surgery service type recorded 76.8% and an evaluation & management service type is 84.6%, a treatment procedure type(85.8%), a function test type(91.6%) and health insurance fee even did not reach to the original cost. Meanwhile, a laboratory test type and imaging test type show high level of cost recovery ratio. they recorded 188.3% and 158.8%. Resultingly now of unbalance in the level of health insurance service fee accelerates supply of every test. so there is a need to make laboratory test type and imaging test type lower to keep balance with the surgery and medical service. These methods should be performed gradually with monitoring the unbalance fee ratio and for this, a panel medical institution have to be established for generalizations of studying result, fairness of selecting researching sample.

• 대한디지털의료영상학회논문지
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• 제17권1호
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• pp.1-7
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• 2015

Recently, dental PACS construction in dental hospital is fairly general. For this reason, inspection request works of dental PACS fee with Health Insurance Review & Assessment Service are more important for the financial stability in hospital and from now on status. But several departments in dental hospital, enforce a incoherent order system so inspection request situation is full of mistakes and omissions. As a result, financial stability in hospital rapidly change for the worse, as the case stands establishment of proper order system and match system is essential to resolve the issue. Consequently, we plan to establish the proposed idealized scheme.

• 한국정보시스템학회지:정보시스템연구
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• 제13권1호
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• pp.121-134
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• 2004

As Internet usage widely grows, online content services such as newspaper, magazine, music, game and movie are provided with a fee-based subscription. Many content services providers consider charging a usage fee into its service provisions as one of the Internet business models for increasing revenue. There are customer resistances to adopting the fee-based service provision on the Web. Previous research in information systems (IS)has focused on the analysis of adoption of information technology or systems in the individual ororganization level. No principle research has been carried out on the user adoption behavior of online content services provisions. As users actively access content services on the Web, it needs to explore user adoption behavior in different settings. Many IS researcher have employedquantitative approaches, even though they deal with the process of user behavior regarding the information technology or system. In this study, we attempt to discover how customers adopt the fee-based provision of online content services by employing grounded theory, one of the principal qualitative research methods.