• 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.

• 한국인터넷방송통신학회논문지
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• 제22권3호
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• pp.151-161
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• 2022

글로벌 CP들로 인해 인터넷의 트래픽이 급증하면서 망 투자비용을 분담하여야 한다는 주장이 업계에서 대두하였다. 이로 인해 망 중립성의 원칙이 접근성에서 비용 부담으로 논점이 크게 바뀌었다. 유료화된 트래픽의 우선처리가 각국에서 인정을 받았음에도 불구하고, 학계의 일부에서는 인터넷 공간에서 망 사용료 지불에 대한 부정적인 시각이 있었다. 그러나 업계에서는 사업자들 사이에 분쟁이 다수 발생하였고, 일부는 법정 다툼으로 비화되면서 법원의 판결에 관심이 쏠렸다. 법원이 망 중립성 하에서 유상성을 인정하기 시작하였고, 정부도 이에 대응하여 규제를 정비하는 등 우리나라는 빠르게 대처해 왔다. 그러나 여전히 서비스 안정에 초점을 맞추고 있으며, 직접적으로 망 이용대가의 지불을 규정한 규제는 아직 없다. 본 연구에서는 망 중립성에 대한 사업자간 분쟁 및 법원의 판결, 규제의 개선 사례를 분석하여 망 중립성의 변화를 고찰하였으며, 공유지의 비극 사례를 참고하여 수익자 부담의 원칙에 입각한 올바른 가격신호의 복원이 가장 중요한 해결책임을 제시하였다. CP의 망 사용료 지급도 그 방안의 하나이다.

• 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.

• 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.

• 한국병원경영학회지
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• 제5권1호
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• pp.200-231
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• 2000

The price systems of the hospital drug services play key roles in the provision of quality services and the development of pharmacy service technologies. Under the premises, this study attempted to determine the costs of hospital drug service, to compare the costs calculated with the fees publicly fixed by the Government, and based on the results of the analysis, to propose directions for the improvement of the price systems. A Costing model for the study was developed based on the cost-fee relationship analysed of the Korean fee-for-service systems. Data on costs and workloads of the 25 hospitals were collected through survey forms designed for the costing' and analysis for the duration of 12 months of 1998. The results of the analysis show that a tremendous unbalance between cost and price levels of the drug services, and that overally the price level of the services is extremely low when compared to the costs of services. Based on these findings, this study suggests that unfairly high or low price level be corrected, and that service items newly developed and being practiced at tertiary hospitals, such as TDM and TPN consultation services, be compensated by fixing a proper level of price.

• 보건행정학회지
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• 제11권2호
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.

• 대한간호학회지
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• 제36권3호
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• pp.503-513
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• 2006

Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

• 보건행정학회지
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• 제29권1호
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• pp.40-48
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• 2019

Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

• 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.

• 한국언론정보학보
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• 제69권
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• pp.139-169
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• 2015

시청자의 공적가치에 대한 기대 및 평가, 인구사회학적 속성을 기준으로 시청자 세분화를 시도하였으며, 도출된 네 가지 군집별로 공영방송 제도 및 수신료에 대해 어떠한 태도 차이를 보이는지 분석하였다. 분석 결과, 집단에 따른 태도의 차이를 확인할 수 있었다. 특히, 20-40대 젊은 여성층이며 '다양성' 차원에서만 공영방송에 대한 높은 기대 수준을 보이고 모든 차원에서 KBS가 수행한 공적가치에 대해 낮은 평가를 보인 집단이 여타 시청자 집단보다 공영방송 제도에 대한 태도가 상대적으로 부정적임을 확인할 수 있었다. 군집별 태도 차이 분석 결과에 대한 확증 및 부연을 위해 공영방송 제도 및 수신료에 대한 태도에 영향을 미치는 변인이 무엇인지 분석하였다. 그 결과, 시청자의 성별, 연령, 소득수준을 비롯하여 '사회적 가치'와 '개인적 실용가치' 차원의 기대, '품질'에 대한 평가 변인이 공영방송 제도에 대한 시청자 태도에 영향을 미치는 것으로 나타났다. 한편, 수신료에 대한 태도는 시청자의 성별과 연령, '개인적 실용가치'에 대한 평가 요인의 영향을 받는 것을 확인할 수 있었다. 공영방송 제도 및 수신료에 대한 태도는 공영방송사가 제시하는 미래 비전에 대한 약속뿐만 아니라, 기존 역할에 대한 평가 요인의 영향을 받아 형성된다는 사실이 본 연구에서 확인되었다.