• Title, Summary, Keyword: Fee for Service

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A Study on Evaluation and Improvement of Long-term Care Hospitals for Changing Long-term Care Hospital Fee System (요양병원형수가제 전환에 대한 요양병원의 평가 및 개선방안 연구)

  • Kim, Young-Bae
    • The Korean Journal of Health Service Management
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    • v.5 no.2
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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.

Determinants of the intention to use information services (서비스 가치 관점에서의 e-정보서비스 사용 의도에 관한 연구)

  • Han Jung-hee;Chang Hwal-sik
    • The Journal of Information Systems
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    • v.13 no.1
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    • pp.97-119
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    • 2004
  • Recently, many e-business companies started to charge fees to the use of information contents service. However, little is known about how users evaluate and determine to purchase information services. Past technology adoption research has focused primarily on the positive utility gains side, focusing on usefulness and ease of use. Purchase of e-service, however, involves not only the position utilities but also negative utilities. This research uses the service value model(SVM) and explains user's intention of purchasing a new information service. Based on the Perceived Value Framework, this research investigates the impacts of the service quality and the fee charge on the user's perceived service value and further on user's intention of adopting the e-service. One of the most important postulations of this research is that both service quality and the fee charge influence user's intention through affecting the user's perceived service value. This research presences a conceptual model of users' e-service evaluation process. The conceptual framework provides a basis for understanding how perceptions of quality and sacrifice influence value perceptions and purchase intentions. The results of an empirical research suggest that the both service quality and fee charge have influences on the perceived service value. However, they do not directly affect user's intention to purchase the e-service. They affect user's intention to purchase through affecting the perceived service value. In conclusion, this research provides a base to build on for other research studying use intention model of new e-service.

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A Study on the Government Regulation with Systems Thinking - Focus on tile Medical Fee Regulation - (시스템사고로 본 정부의 규제정책 - 의료수가 규제를 중심으로 -)

  • Kim, Do-Hoon;Hong, Young-Kyo
    • Korean System Dynamics Review
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    • v.6 no.2
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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.

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Does cost matter: How customer adopts the fee-based online content services?

  • Choi Jeon-Gil;Hong Soon-Goo;Kim In-Jai;Lee Sang-Guen
    • The Journal of Information Systems
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    • v.13 no.1
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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.

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Improvement of estimating method for construction management service fee by case study (사례분석을 통한 건설사업관리 대가산정 방법 개선)

  • Lee, Ung-Kyun;Yoo, Wi-Sung;Kim, Dong-In;Kim, Tae-Hoon;Cha, Min-Soo;Cho, Hun-Hee
    • Korean Journal of Construction Engineering and Management
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    • v.13 no.4
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    • pp.16-24
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    • 2012
  • The objective of this paper is to suggest the improvement of estimating system for construction management (CM) service fee through the analysis of the previous literatures and criteria and case study. In order to do this, this paper considered the relevance of existing criteria to estimate the CM service fee, the condition of input ratio of engineering resources in the real cases, and current utilization strategy of nonresident technical engineers. Based on the analysis, the following problems were identified; a) the different estimating system for CM fee and construction supervision fee, b) impractical estimating system for the CM fee, and c) inappropriate allocation of human resources for CM. Consequently, this paper suggested the following 4 items for the improvement of the existing system; (1) modification of the current structure of CM fee calculation, (2) rationalization of current level of the CM fee which is required to be raised approximately 5.4 percent compared to design or supervision fee, (3) securement of elasticity of the input ratio of engineering resources from the inception phase, and (4) development of the utilization strategy of nonresident engineers based on the technical requirement of the jobsite. Thus, it is anticipated that this research would affect the compensation package of CM in order to make the estimation process of CM service fee more efficient and to revitalize CM as business.

An Analysis on Appropriateness of Health Insurance Fee Using the Activity Based Costing(ABC) Approach (활동기준 원가분석을 통한 건강보험수가의 적정성 분석)

  • Kim, Han-Sung;Shin, Hyun-Woung;Cha, Jae-Young
    • Korea Journal of Hospital Management
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    • v.20 no.3
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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.

Comparison Actual Conversion Factor with Estimated Conversion Factor by Fee Adjustment Model Reflecting Health Service Volume (서비스양을 고려한 수가 결정모형에 의한 추정 환산지수와 실제 환산지수의 비교)

  • Han, Ki Myoung;Cho, Min Ho;Lee, Soo Jin;Chun, Ki Hong
    • Health Policy and Management
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    • v.23 no.4
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    • pp.343-348
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    • 2013
  • Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta's fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.

Development of a Nursing Fee Schedule Model (적정간호수가 산정모형 개발을 위한 연구)

  • 조소영;박정호
    • Journal of Korean Academy of Nursing
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    • v.23 no.1
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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.

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A Study on Estimating the Appropriate Fee of Aids to Navigation Service for the Pyeongtaek Regional Office of Oceans and Fisheries (평택지방해양수산청의 적정 항로표지이용료 추정에 관한 연구)

  • Moon, Beom-Sik;Jeon, Gi-Jun;Kim, Tae-Goun
    • Journal of Navigation and Port Research
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    • v.44 no.4
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    • pp.347-353
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    • 2020
  • Aids to Navigation (AtoN) contribute to preventing marine accidents and protecting marine environment by providing various information such as location information etc. to ships. Recognizing the importance of the AtoN, a 24 won of the AtoN service fee is charged for ships entering and leaving international trade ports. However, while the 24 won of the AtoN service fee has been maintained since its establishment in 1999, the demand for new roles of the AtoN service for autonomous shipping and smart port operations, etc. has gradually increasing with the change of shipping and port 4.0. Thus the purpose of this study was to estimate the appropriate level of the AtoN service fee in accordance with such changes in the shipping and port industries. To accomplish this, a method of recovering the total cost was introduced to the PROOF (Pyeongtaek Regional Office of Ocean and Fisheries). It is estimated that there are four cases in which estimation of the AtoN service fee is estimated in two cases year by year and conversion year, the AtoNs of PROOF are classified into the all and part of a ship using the trade port. As a result of the estimation, the AtoN service fee of PROOF is estimated at 53.78-71.62 won (as of 2019), and 29.78-47.62 won is higher than the today at 24 won. The results of this study can be used as useful basic data for the operation of budgets and policy management considering the role of the AtoN.

Medical Services for Cesarean Section Cases in One DRG Pilot Study Hospital (질병군별 포괄수가제(DRG 지불제도) 시범사업에서 제왕절개산모의 의료서비스 - 서울시내 한 종합병원을 대상으로 -)

  • Lee, Kwi-Jin;Yu, Seung-Hum
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.21-40
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    • 1999
  • One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

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