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

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Analysis of Consumer's Recognition and Satisfaction for the Improvement of the Doctor-Designation System (선택 진료 제도 개선을 위한 소비자 인식도와 만족도)

  • Im, Bock-Hee
    • Journal of Digital Convergence
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    • v.12 no.6
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    • pp.385-396
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    • 2014
  • The purpose of this study was to examine the recognition of citizens in Busan on the doctor-designation system, the awareness of medical consumers with experience of using this system and their satisfaction in an effort to seek ways of improving this system. The subjects in this study were the selected citizens in Busan who were at the age of 20 and up. As a result, it's found that the largest group of the respondents was female, in their 20s, received college or higher education, students and in the service industry, and that the most common monthly mean income was between two and 2.99 million won. 27.7 percent were aware of the doctor-designation system, and 23.7 percent became cognizant of the system through others who had used it. The rate of knowing the rules of the doctor-designation system (the right answer) stood at 66.3 percent. They got to know about the system through mass media(31.9%), and used it since it offered highly specialized treatment(57.5%). The respondents who had used it intended to reuse it(76.3%), and the reason was that they were provided with high-class medical services (35.2%). The respondents who had used this system got a mean of 2.96 in satisfaction level, which was not high in general. They mentioned more publicity efforts(91.2%), offering information in a conspicuous place (96.7%) and cutting doctor-designation treatment fee as a means of improving this system. As for how to ensure the operating efficiency of the system, sustained publicity seem to be necessary to raise awareness of the system among patients, and it's required to take measures to relieve patients of financial burden caused by medical bills.

What Can Koreans Learn from the Dutch Experiences in Reforming the Health Insurance System? (한국의료보험제도(韓國醫療保險制度)의 개혁필요성(改革必要性)과 네덜란드의 경험(經驗)이 주는 교훈(敎訓))

  • Kwon, Soon-won;Sunwoo, Duk
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.47-69
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    • 1990
  • The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.

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The Comprehensive Management Indexes and Their Application Strategies for Appropriate Medical Care in Primary Care Clinics Under Workers' Compensation Insurance (산재보험지정의원 요양급여적정성 종합관리지표 산출 및 적용방안)

  • Bang, Eun Ju;Choi, Eun Sook;Ko, Young
    • Korean Journal of Occupational Health Nursing
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    • v.17 no.1
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    • pp.86-95
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    • 2008
  • Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.

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A Study on the Student Housing in the Regional University -Focused on the University at Hongsung Kun, Chungnam- (지방대학교의 학생주거에 관한 연구 -충남 홍성군 소재 대학교를 중심으로-)

  • 이선희
    • Korean Institute of Interior Design Journal
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    • no.25
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    • pp.142-148
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    • 2000
  • The purpose of this study is to provide a practical guide for the actual conditions and the preference of student housing in a regional university. The data are collected through questionnaire surveys from the students of a regional university. 265 samples are collected, and are analyzed by using SPSS-PC. The results are as follows: 1) The actual conditions of student housing Most residents of student housing(76.3%) come from the Capital region. Most of student housing are located at 30 minute distance from the school. Most of house style are Offistel as one room style. Most of housing size are within 10 minute distance from the school. Most of house style are Offistel as one room style. Most of housing size are within 10py, and two people reside in one unit. The average hours of staying at the student housing are over 10 hours. The most inconvenient factor is the lack of soundproofing in the current student housing. 2) The preference of student housing The most preferred location is in the walking distance from the school, and the apartment is the most preferred housing style. The most preferred installation of inside is internet connection. When choosing student housing, students prefer the distance from the school as the most important factor. Most female students reside with a roommate within 10 py of housing size, cook for themselves, and consider rent and maintenance fee as the decision factors in choosing housing. The most preferred style of house is apartment, and they prefer to install basic furniture and kitchen system inside of housing. As students go up to higher grade, they prefer the apartment, and prefer to cook for themselves. More fresh men reside with a roommate compared to other grades. They prefer Offistel with meals service at a walking distance from the school.

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Analysis of HACCP System Implementation on Productivity, Advantage and Disadvantage of Laying Hen Farm in Korea (산란계 농장의 HACCP 제도 적용에 따른 생산성과 장단점 분석)

  • Nam, In Sik;Kim, Hyung Sik;Seo, Kang Min;Ahn, Jong Ho
    • Korean Journal of Poultry Science
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    • v.41 no.2
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    • pp.93-98
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    • 2014
  • This study was conducted to analysis the reason for implementing HACCP system, advantage and disadvantage of HACCP system implemented laying hen farm. The study was carried out by randomly selected fifteen laying hen farms located in all around Korea. All data were collected from fifteen laying hen farms before and after the implementation of HACCP system. The results were as follows: The egg production rate, livability rate and monthly used animal medicine fee did not changed after HACCP system implementation. However, monthly used disinfectant fee tended to be higher in HACCP farm compared to non-HACCP farm. 26.92% of the laying hen farmer responded enhancement of their farm competitiveness as the major propose for implementing HACCP system. The advantages of HACCP implemented laying hen farms were methodical farm management (22.39%), improvement of awareness (21.18%), improvement of the farm sanitation management level (15.30%), safety egg production (15.05%), productivity enhancement (7.29%), reduction of mortality rate (6.82%), and improvement of labor's welfare (5.89%). The disadvantages of HACCP implemented laying hen farms were HACCP recording (43.30%), alteration of consciousness (22.60%), HACCP monitoring (11.11%), HACCP education (9.97%), HACCP verification (6.90%), and A high turnover of labor (6.13%). In conclusion, implementation of HACCP system to laying hen farm did not affect on the productivity or the use of animal medicine. However, the HACCP system may enhance safety and sanitation of egg production for consumer.

Economic Length of Stay and Opportunity Income of Appendectomy and Pneumonia Using Activity-based Costing (활동기준원가를 이용한 충수절제술과 폐렴의 경제적 재원일과 재원일 단축에 따른 기회이익)

  • Kim, Sang Mi;Lee, Hae Jong;Shin, Dong Gyo
    • Health Policy and Management
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    • v.23 no.2
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    • pp.124-131
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    • 2013
  • Background: This study aimed to measure the opportunity income by identifying the economic length of stay (ELOS) which is the intersection point of daily revenue and cost on appendectomy and pneumonia cases. Methods: The research subjects were 460 patients of appendectomy and 606 patients of pneumonia, discharged from a general hospital between July 1, 2009 and June 30, 2010. ELOS calculated with both of total revenue on diagnosis-related group (DRG) and fee-for service (FFS). The cost is calculated by activity-based costing system of the hospital. Results: Average length of stay (ALOS) of appendectomy was 4.48 days and its average revenue per case were 1,710,215 (1,989,105) won by DRG (FFS). The variable cost was 491,262 won which was 28.7% (24.7%) of DRG (FFS) total revenue. And 97.2% of the total variable cost was incurred within 2 days from admission. The ELOS was 4 (5) days in DRG (FFS). Shortening three days (two days) would increase opportunity income 52.0% (82.2%) in DRG (FFS). ALOS of pneumonia case was 4.86 days and its average revenue per case were 489,448 (761,426) won by DRG (FFS). The variable cost was 27,230 won which was 5.6% (3.6%) of DRG (FFS) total revenue. Thirty-eight point nine percent of the daily variable cost was incurred in discharge date. The ELOS was 2 (4) days in DRS (FFS). Shortening three days (one day) would increase opportunity income 27.6% (37.2%) in DRG (FFS). Conclusion: The ELOS would be used by strategic index for achieving minimum profit and developing the ways to get there. But we also should not pass over that the opportunity income obtained by the reducing ALOS may cause some problem of quality.

The Real Picture of the Care Costs Paid to Korean Oncology Advanced Practice Nurses (종양전문간호사 업무에 대한 수가 실태)

  • Kim, Dal-Sook;Kim, Soo-Hyun;Kim, Kwang-Sung;Jun, Myung-Hee;Kim, Jin-Hyun;Lee, Hyun-Joo
    • Asian Oncology Nursing
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    • v.11 no.2
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    • pp.155-162
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    • 2011
  • Purpose: The purpose of this study was to examine the actual care costs paid to Korean Oncology Advanced Practice Nurses (KOAPN). Methods: We collected data using a group discussion and questionnaire identified 115 tasks from job descriptions developed by the Korean Accreditation Board of Nursing. Forty-two KOAPN working at three university hospitals in Seoul were asked to evaluate each task as to type and whether the cost is paid or not. They were also asked to indicate the tasks in urgent need of development of a care cost with high priority. Results: Only five tasks (4.3%) related to treatment and complication related interventions or education were paid, and they were paid only once during the entire treatment period and were not covered by national health insurance. It was approved as a medical fee by health insurance review & assessment service. Furthermore, the names of the authority (doctor) and the actual provider (nurse) of the prescriptions were different for three of those tasks. Most of the suggested tasks needing development of care costs were actions specifically performed by nurses (physical-psychosocial-spiritual assessment, independent nursing interventions). Conclusion: KOAPN are currently paid for few tasks. To maximize the utilization of KOAPN, the establishment of a clear rational payment system directly related to their actual activities is needed.

Inland Logistics Forwarding System based on Supply Chain Management : ILOF (공급사슬기반의 육상물류중개시스템 개발에 관한 연구)

  • 박남규;최형림;김현수;박영재;손형수
    • Journal of Information Technology Application
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    • v.3 no.2
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    • pp.67-82
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    • 2001
  • The ILOF project addresses the needs of logistics industrial organizations to reduce information processing time, improve added and residual value of information and reduce processing and transportation costs. It deals with the information supply chain information systems shared by vertical partner as important entity, whose performance and optimization very significantly affects the efficiency and performance of logistics industries. This paper deals with logistics information exchange systems based on supply chain management, focusing on sharing database and processes between partners such as shipper, logistics broker, transportation company, shipping company etc., for smoothing the information flow, enhancing consumer service and reducing communication fee and labour costs. The significance of contribution of this research is the provision of a model for logistics information exchange including entity relationship diagram, data flow diagram and functions which is able to facilitate the formulation of a customer driven supply chain information network, there by enhancing the competitive edge of companies in logistics industries on local and global basis.

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Impacts of DRG Payment System on Behavior of Medical Insurance Claimants (DRG 지불제도 도입에 따른 의료보험청구 행태 변화)

  • Kang, Gil-Won;Park, Hyoung-Keun;Kim, Chang-Yup;Kim, Yong-Ik;Ha, Beom-Man
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.393-401
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    • 2000
  • Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

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Comparative Study of the Effects of the Intermodal Freight Transport Policies (인터모달 추진 정책과 효과에 관한 비교연구)

  • Woo, Jung-Wouk
    • Journal of Distribution Science
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    • v.13 no.10
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    • pp.123-133
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    • 2015
  • Purpose - The Korean government has devised intermodal transportation policies and granted subsidies to shippers and logistics companies that made a conversion of transportation means through the policies. This provides support by expanding the complex uniform railroad transportation and overhauling the deteriorated railroad facilities. As for 2013, however, the freight transportation percentage of railroad was 4.5% in tons and 8.5% in ton kilometers. Meanwhile, since the 1990s, developed countries such as the U.S. and Europe have been trying to expand intermodal freight transport with a legal and institutional support to build a logistics system corresponding with social and economic environmental changes. In this study, I set out to examine the effects of the intermodal freight transport policies in the EU and the U.S., and to explore the direction of setting up a rail intermodal transport system in South Korea. Research design, data, and methodology - The paper used a qualitative research methodology through the literature review. First, was an overview of Intermodal transportation in the EU, U.S. and UN. Second, it describes the development of transport in Europe and the U.S. with particular emphasis on intermodal freight transport. Third, it explores the direction of setting up a intermodal freight transport in South Korea. The last section contains concluding remarks. Results - As for the EU, it has been promoting integration between transport and intermodal logistics network designs while utilizing ITS or ICT and supports for rail freight intermodal by giving reduction to a facilities fee or subsidizing for rail freight in order to minimize the cost of external due to freight transport. On the other hand, as for the U.S., it has been made up of an industrial-led operating project and has been promoting it to improve accessibility between intermodal hubs and cargo terminals through intermodal corridor program, and an intermodal cargo hub access corridor projects, etc. Moreover, it has tried to construct intermodal transport system using ITS or ICT and to remove Barrier. As a result, in these countries, the proportion of intermodal freight transport is going to be the second significant transport compared with rail and maritime transport. An Effective rail intermodal transport system is needed in South Korea, as seen in the case of these countries. In order to achieve this object, the following points are required to establish radical infrastructure policy; diversify investment financing measures taken under public-private partnerships, legal responsibilities, improvement of utilization of existing facilities to connect the railway terminal and truck terminal, and enhancement service competitiveness through providing cargo tracking and security information that combines the ITS and ICT. Conclusions - This study will be used as a basis for policy and support for intermodal freight transport in South Korea. In the future, it is also necessary to examine from the perspective of the shipper companies using the rail intermodal transport, ie, recognition of shipper, needed institutional supports, and transportation demand forecasting and cost-effective analysis of the railway infrastructure systems improvement.