A Study on Characteristics of Medical Expenses and the Hospitalization Period of Hospitalized Patients Using Diem Payment System at Convalescent Hospitals

요양병원 일당정액제 입원환자의 입원일수 및 진료비 특성에 관한 연구

  • Received : 2016.07.19
  • Accepted : 2016.08.11
  • Published : 2016.08.31


This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.


Appropriateness scheme;Convalescent hospitals;Length of hospitalization;Total treatment expenses


  1. H. J. Song, Current situation and policy challenges of long-term care hospitals, HIRA policy trends of Hearth Insurance Review&Assessment Service, vol. 5, no. 3, 2011.
  2. D. H. Kim, Comparison of entecavir and clevudine for treatment of chronic hepatitis B, The Korean Journal of Medicine, vol. 78, no. 5, 2010.
  3. T. Y. Lee, W. K. Lim, A Study on the Relationship Among the Patient Caregiver's Consumption Value and Hospital Satisfaction, Psychological Well-Being in Geriatric Hospitals, Journal of Digital Convergence, vol. 12, no. 12, pp. 61-76, 2014. DOI:
  4. Y. K. No, The need for role establishment of long-term care hospital care and long-term care hospitals for the elderly long-term care, HIRA policy trends of Hearth Insurance Review&Assessment Service, vol. 5, no. 3, pp. 23-33, 2011.
  5. H. S. Jang, The structural causes and perpetuating factors affecting long-term hospitalization of the mentally ill in Korea. Graduate School University of Ulsan, 2010.
  6. M. Jang, An analysis of the relationships between inpatients' characteristics, and there duration and costs : the case of S university hospital. Graduate School of Administration SungKyunKwan University, 2004.
  7. H. J. Lee, Determining factors of elderly supporter's intention on nursing hospital utilization, The Graduate School of Ewha Womans University, 2007.
  8. J. H. Kim, Problem analysis for the improvement of long-term care hospital payment system, HIRA policy trends of Hearth Insurance Review&Assessment Service, vol. 9, no. 3, pp. 52-65, 2015.
  9. Y. H. Heo, A Study on Drug awareness information, Usage and Misusage on Elderly Inpatients of Veterans Hospital, Journal of the Korea academia-industrial cooperation Society, vol. 14, no. 9, pp. 4326-4334, 2013. DOI:
  10. Hearth Insurance Review&Assessment Service, Medical Expense of Health Insurance in 2015, p.713, Hearth Insurance Review&Assessment Service, 2015.
  11. D. H. Kim, Increase transition of the number of patients and the number of days in the hospital due to the increase of long-term care hospital beds, HIRA policy trends of Hearth Insurance Review&Assessment Service, vol. 7, no. 3, pp. 53-61, 2013.
  12. D. J. Lee, S. H. Ko, Y. H. Lee, Perception and practice of hospital infection control in nurses of geriatric hospital : for convergent approach, Journal of Digital Convergence, vol. 13, no. 11, pp. 461-470, 2015. DOI:
  13. Hearth Insurance Review&Assessment Service. Medical Expenses Statistical indicators in 2014, 2015.
  14. Y. J. Yang, Study of Management and Environmental Factors Affecting Medical Expense Reduction, Journal of Digital Convergence, vol. 10, no. 11, pp. 493-502, 2010.
  15. J. H. Lee, M. S. Lee, J. H. Kim, T. Y. Moon, Y. H. Kim, K. H. Kim, Analysis of Factors which Affect the Medical Utilization Fee after an Increase of Health Insurance Benefits for Patients with Serious Illnesses, Journal of the Korea academia-industrial cooperation Society, vol. 11, no. 4, pp. 1504-1510, 2010.
  16. S. S. Kim, W. J. Kim, S. H. Kang, A study on the variation of severity adjusted LOS on Injury inpatient in Korea, Journal of the Korea academia-industrial cooperation Society, vol. 12, no. 6, pp. 2668-2676, 2011. DOI:
  17. J. S. Yun, K. H. Kim, Effect on Medical Expenses Request due to Medical Clinic Administrative Staff's Existence or Not, Journal of Digital Convergence, vol. 10, no. 1, pp. 407-412, 2012.
  18. Statistics Korea, The Sixth Revision of the Korean Standard Classification of Diseases(KCD-6), 2010.
  19. Statistics Korea, Korean Standard Classification of Diseases Coding Guidelines. 2014.
  20. Hearth Insurance Review&Assessment Service, Medical care on the basis of analysis of health insurance claims data for the production manual-to center the construction of analysis, 2015.
  21. Hearth Insurance Review&Assessment Service, Long term care hospital medical insurance fee, pp. 10-12, 2007.