The Income and Cost Estimate for the Medical Clinic Services Based on Available Secondary Data

이차자료원을 활용한 의원 의료서비스 수입 및 비용 산출

  • Kim, Sun Jea (Health Insurance Research Institute, National Health Insurance Service) ;
  • Lim, Min Kyoung (Health Insurance Research Institute, National Health Insurance Service)
  • 김선제 (국민건강보험공단 건강보험연구원) ;
  • 임민경 (국민건강보험공단 건강보험연구원)
  • Received : 2021.02.18
  • Accepted : 2021.03.25
  • Published : 2021.03.31

Abstract

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

Keywords

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