• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.345-352
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• 2020

This study conducted a survey targeting 414 medical institution workers to identify the impacts of their emotional labor and the recognition level of medical service fee reduction influencing the reduction rate. The results were as follows. First, a review of the difference in the reduction rate by socio-demographic characteristics revealed that in both inpatient and outpatient reduction rate, there is a significant difference in the occupational description, working history at the current hospital, and the numbers of approved beds. Second, there is a correlation between emotional labor, the recognition level of medical service fee reduction, and the reduction rate. As a result of the analysis, there is a significant positive correlation between emotional labor and outpatient reduction rate, a significant negative correlation between the recognition level of medical service fee reduction and inpatient reduction rate, and a significant negative correlation between the recognition level of medical service fee reduction and outpatient reduction rate. Third, emotional labor has a significant positive effect on the inpatient reduction rate, and the recognition level of the medical service fee reduction has a negative effect on the inpatient reduction rate. The emotional labor also has a significant positive effect on outpatient reduction rate, and the recognition level of the medical service fee reduction has a significant negative effect on outpatient reduction rate.

• Korea Journal of Hospital Management
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• v.12 no.2
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• pp.1-24
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• 2007

The medical fee reimbursement denied by HIRA(Health Insurance Review Agency) amounted to about 1.2% of the total medical fee claim to HIRA for reimbursement. Most of the denials stem from the inappropriate prescriptions of medical staff violating the medical fee review standards issued by HIRA. Considering the significant impacts of the standards observance behavior on the hospitals' financial viability, we attempted to analyze the predisposition factors of medical staffs' review standards observance behavior. The TPB(Theory of Planned Behavior) was adopted as the theoretical framework of the analysis. Data were collected by administrating a survey on the concepts included in TPB model to the 187 medical staff of a tertiary care hospital. Of the 187 questionaries distributed, 150 were responded resulting 80.2% of response rate. The mean differences among the groups classified by age group, years of experience, medical specialty and gender were analysis using ANOVA. The relationships among the TPB concepts were analysed by applying the Structural Equations Modeling method. The TPB model consists of three exogenous concepts (attitude toward the behavior, subjective norm, and perceived behavioral control) and two endogenous concepts (intention and the behavior). The results of ANOVA indicated significant mean differences among the groups classified by the medical staff's age, years of experience, and medical specialty. The older and the more experienced had the higher mean of observance behavior score. The results of Structural Equations analysis showed that the subjective norm and perceived behavioral control had statistically significant influences on intention, but the influence of attitude to intention was not statistically significant. The influences of perceived behavioral control and intention on behavior were significant. Based on these results the theoretical and practical implications were discussed.

• Health Policy and Management
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• v.6 no.2
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• pp.115-130
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• 1996

This study was performed to investigate the practical oriental medical expenses by the use of internal data of an oriental hospital due to the bias of medical insurance program data. The purpose of this study was to describe prevalent diseases of clinical department in the studied hospital, to analyze medical expenses structure and to verify the each cost share ration of expenses on insurer to insuree. Under this purpose, we analyzed actual medical expenses data of 1,611 hospitalized patients of the oriental medical university hospital with 150 beds that can be approached to internal data from Jan. 1, 1994 to Dec. 31, 1994. The major findings are as follows : 1. Upper five of most frequent diseases of admitted patients were Joul-Jung-Pung(55.5%), Yoo-Kak-Tong(7.3%), Yoo-/Tong(7.1%), Gu-An-Wa-Sa(2.7%) and sequale of Joul- Jung-Pung(2.4%) 2. In medical expenses structure, hospital ward fee was 47.1%, medication fee 41.3%, fee for procedure(acupuncture, moxibustion, negative therapy, physical therapy, etc) 11.1% and consultation fee 0.5%. In addition to the cost share ration of insuree & that of insurer was 75:25 respectly.

• The Journal of Korean Medicine
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• v.34 no.1
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• pp.35-51
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• 2013

Objectives: The purpose on this study was to analyze medical health insurance to provide useful data to reestablish oriental medical insurance fees for long-term care hospitals. Methods: First, comparative analysis on medical health insurance was performed, calculating insurance fees of patients admitted to Mungyung Long-term Care Hospital. The oriental medical insurance fee of the patients was calculated as if the patients have been admitted to oriental long-term care hospitals, and the ratio of oriental medical insurance fee to western was calculated. Results: 1. The ratios of total medical expenses were 90% within 3 months and 82% over 3 months. 2. The ratios of co-pays were 86% within 3 months and 82% over 3 months. Conclusions: Oriental medical insurance fees need to be reevaluated.

• Health Policy and Management
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• v.2 no.1
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• pp.1-16
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• 1992

This study compares the physician payment of national fee schedule for Korean Medical Insurance with that of the United States based on Resource Based Relative Value Scales (RBRVS) which Hsiao developed in 1988 for the Medicare reimbursement. Through the comparison of two fees schedules, this study is purposed to evaluate the appropriateness of relative values which assigned to each physician services of Korean fee schedule. A total of 264 physician services are selected for the comparison. The ratio of Korean schedule to RBRVS is selected as an index of appropriateness. It the score of index shows large variation among services, the relative value of Korean fee schedule is inappropriate with U.S. RBRVS which was developed recently. The Ratios of Korean schedule to RBRVS are widly variated ; the range of those is 8.1 to 379.3. In subgroups which are regrouped to controll systematic differences between two national fee schedules, these ratios are also variated. Services which are relatively less compensated are management/evaluation services, while services which are relatively more compensated are invasive and imaging services. By the way, the service classification of Korean fee schedule is unclear, specially in management/evalutaion services. Therefore, Korean Medical Insurance fee schedule should be modified to be more balanced and rational.

• Health Policy and Management
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• v.31 no.4
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• pp.399-408
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• 2021

The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.

• Journal of Korean Public Health Nursing
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• v.2 no.2
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• pp.21-44
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• 1988

In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1038-1052
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• 2020

Advancements of medical care with the use of new medical technologies have been promoting public health, but they can also place a financial burden on individuals and the country. Since the introduction of the health insurance system in 1977, the South Korean government has been attempting to control medical expenses. Radiological examinations have been a major target for cost reduction. Meanwhile, the radiological report fee has been combined with the technical fee for a long time; hence, its value has not been independently evaluated, and was also decreased proportionally with examination cost reduction. However, in the revised medical fee estimation system for MRI, the report fee has begun to be calculated separately from the technical fee, significantly contributing to the evaluation of the radiologists' work value. In conclusion, radiologists need to know and actively participate in the process of determining the insurance cost of radiological examinations and reports to get a proper value of their professionalism.

• Korean Institute of Interior Design Journal
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• v.19 no.4
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• pp.99-108
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• 2010

The goal of This study is to predict medical fee by accidents at home and the factors of accidents, and also to suggest the conditions of housing adaptations for elderly people. As the result of in-house accidents, on average 2.97 million Korean won was to be spent for medical care. Furthermore, 2808 billion Korean Won, which was predicted by multiplying the number of older people with the reported accident rates of 2.0% by the National Health and Nutrition Survey 2005, can be estimated to pay on medical care in 2005. And in addition it is analyzed on residential conditions and 65 cases of elderly housing. According to the 65 safety problem cases, it examines that in-house accidents of older people generally happen at the steps, toilet and bathroom. It is necessary to adapt physical conditions and it is more effective. As the result of research, medical fee by accident at home has been increasing and also it could be predicted to spend 280,800million won in 2005. To reduce medical fee, it is necessary to promote physical environment by renovation. When be decided to renovate a housing, we know that it is more effective to use a checklist of space using at home. And also it is suggested to amend a checklist with other factors including physical conditions and health condition and so on to promote a correctness.

• Journal of radiological science and technology
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• v.37 no.4
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• pp.315-322
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• 2014

This study demonstrates holding condition of CT by medical institution classification and by season, and examination fee in Korea currently to quantitatively understand frequency of examination region by change of CT equipment, domestic growing trend and change of distribution and using rate. Recent 10 years of CT holding condition by medical institution classification (Tertiary hospital, General hospital, Hospital, Clinic, Dental hospital, Dental clinic, Hospitalized health center) and by year (2003-2012), and CT examination fee of distribution of medical institution by year is surveyed. The holding ratio of Tertiary hospital level and General hospital level is 32.7% in 2003 and 33.0% in 2012. Whereas, Hospital and Clinic level is 74.2% in 2003 and 66.8% in 2012, which takes approximately 70%. Based on data in 2012, it is 82.2% of total examination fee in Tertiary hospital and General hospital, while 17.5% in hospital and clinic. CT holding rate of Hospital level is increasing, while Clinic level is decreasing. Approximately 80% of CT examination fee is claimed by Tertiary hospital and General hospital. Therefore, there is a significant correlation between CT holding condition of medical institution classification and examination fee. Particularly, correlation between CT holding number of Tertiary hospital and examination fee is significant (p<.001). The more CT holding number, the higher the amount claimed examination fee.