• Title/Summary/Keyword: Oriental medical insurance fee

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The Current Status and Medical Fee Propriety of Psychotherapy and Neuropsychological Test for Dementia in Korean Medicine (한방정신요법 및 치매 검사의 현황, 수가 적절성 연구)

  • Jang, Jae-Soon;Hwang, Wei-Wan;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.4
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    • pp.411-422
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    • 2014
  • Objectives: A large number of patients require psychiatric therapy. We attempted to determine the present situation regarding psychotherapy and neuropsychological tests for dementia in Korean medicine for the benefit of the Health Insurance Review and Assessment Service (HIRAS). The aim of this study was to aware of the current status about psychotherapy and neuropsychological test for dementia in Korean medicine. Methods: We searched the medical practice records for psychotherapy and neuropsychological tests in oriental neuropsychiatry between 2009 and 2013 using the Health Insurance Review and Assessment Service (HIRAS) database. The search categories were: IJeongByunGi (Medical practice code:59001), JiUnGoRoen (59002), Kyungjapyungji (59003), OhJiSangSeung (59004), neuropsychological test for dementia (29005). Results: 1. The number of patients treated with Korean Medical Psychotherapy increased annually by 151%. The total number of patients treated with Korean Medical Psychotherapy was 4,289 in 2013. 2. The total cost for patients treated with Korean medical Psychotherapy in the public health medical insurance budget was 268,032,000 won in 2013. The average medical cost for one therapy was 17,000 won in 2013. 3. The number of patients in local clinics is increasing faster than the number in Korean medical hospitals. 4. The age group between 20~30 years of age, for both men and women, is the group with the greatest density in Korean Medical Psychotherapy. 5. Neuropsychological Testing for Dementia in Korean Medicine is slowly decreasing. Conclusions: The prevalence of mental illness in Korea is increasing, therefore, the demand for Korean Medical Psychotherapy has increased recently. Authorizing Korean Medical psychiatrists to utilize Korean mental Health resources is essential. This study could be helpful in understanding the current status for the purpose of expanding Korean Medical Psychotherapy.

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;Lim, Min Kyoung
    • Korea Journal of Hospital Management
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    • v.26 no.1
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    • pp.71-82
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    • 2021
  • 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.

KAP Study on Oriental Traditional Doctor, Hospital and Medicine in Korea (최근 일부 한국이의 한의사.한방의료기관 및 한의학 관련 인식 태도 및 의료행위에 관한 연구)

  • Lee Sun-Dong;Park Kyong-Sik
    • Journal of Society of Preventive Korean Medicine
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    • v.1 no.1
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    • pp.27-41
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    • 1997
  • The degree of KAP study on oriental traditional medicine was examined with some korean from July 1st to August 30th in 1996. The result of the study for predicting health and ill patterns runs as fellows. 1) It is too weak to understand and adertise oriental traditional medicine doctors and the curable disease; moreover cured diseases rather preponderate. 2) Although most patients go to oriental traditional medical clinic for the purpose of medical herbs in package and acupuncture, they think the medical fee a high expensive. 3) The 77.9% of respondents recognize oriental traditional medical doctors as a profession and others think them only abundant workers; therefore it is rather low to think oriental traditional doctors a profession. 4) Most respondents ink that oriental traditional medicine should improved in the inside; such as the expensive fee, scientific reinforcement of theory, lack of univerality, improvement and enlargement of insurance, unkindness, shortage of publicity, dropped equipment, system of medical specialist, lack of integration with western medicine, exact diagnosis and confidence of remedy and low efficacy, etc. 5) The struggle against the government (1995-1996 about herbal prescription right by western pharmacy) has taken the change of affirmative recognition. 6) The degree that acknowleges of oriental traditional medicine through these basic contents is average 61.65 mark. To be brief, although the step of recognition and attitude of oriental me야cine is very affirmative aspect, actually considerable difficult factors is in the last chosen step.

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A Study on the Clinical Statistics of an Oriental Medical Office in a Public Health Center (대도시 보건소 한방 진료실 이용실태)

  • Kim, Ki-Tae;Ko, Heung;Lee, Eun
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.827-835
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    • 2006
  • Objectives : This study investigated the actual condition of an oriental medical office in a public health center. Methods : We classified patients who visited an oriental medical office in the public health center of Gyeyang-gu over a 1-year period, according to age, sex, disease, etc. The number of patients was 6529. Results : Analyzing these 6529 persons, 65.8% were female, and 79.6% were seniors aged over 65. By disease category motor systemic disease or circulatory disease affected 84% of the patients. By medication or treatment category. O-Juk-San (五積散) at 38.3% was the greatest proportion, and Pal-Mul-Tang (八物湯) the second greatest. As to medical fee, 80.2% of the patients were not charged for treatment. Conclusions : The extract of herbal medication should be more expanded in the medical insurance, and should be improved in quality. The oriental medical office in a public health center should focus more on health promotion and disease prevention than patient care. For accomplishing this goal, the institutional position and rights of oriental medical doctors as civil officials should be equal to those of western medical doctors.

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Analysis of the propensity of medical expenses for auto insurance patients by type of medical institution (의료기관 종류별 자동차보험 환자의 진료비 성향 분석)

  • Ha, Au-Hyun
    • Journal of Convergence for Information Technology
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    • v.12 no.2
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    • pp.184-191
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    • 2022
  • This study aims to provide basic information necessary to find an efficient management plan for patients using auto insurance. The analysis was conducted on the five-year auto insurance medical expenses review data registered in the health care bigdata Hub from 2016 to 2020. As a result of the analysis, the number one composition ratio of auto insurance inpatient treatment expenses was treatment and surgery fees for Certified tertiary hospitals, hospitalization fees for general hospitals, hospitals and clinics, and treatment and surgery fees for oriental medical institutions and dental hospitals. outpatient treatment expenses was doctor's fee for medical institution, treatment and surgery fees for oriental medical institutions and dental hospitals. The ratio of medication, anesthesia, and special equipment significantly affected the cost of inpatient. And the ratio of physical therapy significantly affected the cost of outpatient.

A Analysis of Patients Using Korean Medicine Clinics -Analysis of Outpatients and Inpatients by Age, Sex and Regions- (한방의료기관에서 치료하는 환자의 의료이용분석 -외래 및 재원입원환자의 성, 연령, 지역별 분석을 중심으로-)

  • Choi, Sung-Yong;Shin, Hyun-Kyu;Park, Hae-Mo;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.2
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    • pp.67-81
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    • 2012
  • Objective : This study aimed to analyze the utilization of Korean Medicine clinics, and high-frequent diseases by sex, age, and region of outpatients and inpatients Methods : The data for this study were "Report on Usage Patterns of Korean Medicine Clinics" issued by the Ministry of Health and Welfare in 2008. Descriptive analysis and correspondence analysis were used to find the patterns of patient's utilization by sex, age and region Results : Diagnosis and examination methods mostly consisted of the pulse for diagnosis. Treatment methods consisted of acupuncture, medical herbs in package, and insurance extract powder. Fee for consultation was paid by Korean Medicine insurance. Usage increased when people's age was over 20 and climaxed among people who were in their 40s and 50s and decreased gradually afterwards. Also, there were differences between the sexes. There were differences in high-frequent diseases by regions, and in usage of Korean Medicine clinics according to sex and age. Conclusion : It was found that there were differences in usage and patterns of Korean Medicine Clinics according to sex, age, and region.

Trend analysis of financial balance of Korean medicine clinics during 20years(1987~2007) (20년간(1987년~2007년) 한의원 경영수지의 경향 연구)

  • Kim, Dae-Hun;Lim, Byung-Mook
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.2
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    • pp.41-52
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    • 2012
  • Objectives : This study aimed to analyze the trend of financial balance of Korean medicine clinics during 20 years, and to provide basic information for adjusting the fee schedule of Korean medicine procedures in national health insurance(NHI). Methods : We collected 6 financial analysis reports for Korean medicine clinics from the Association of Korean Oriental Medicine(AKOM). The data on incomes, costs and EBIT(earning before interests and taxes) of subject clinics were abstracted, and their long-term trends were evaluated. Results : The proportion of insurance income in total income increased from 23% to 56% during 20 years. Among 5 treatment groups, 'non-insurance medication' took up 65~67% of total incomes in 1997, but its proportion decreased to 42.4% in 2007. 'medical procedure, physical therapy and others' increased from 12.4% in 1987 to 29.2% in 2007. The labor cost was major part of total cost and its proportion maintained from 52% to 54%. Cost of 'non-insurance medication' was on the decline from 41% in 1996 to 31.6% in 2007. EBIT were -17.4 million won in 1996, and 18.4 million won in 2007. Conclusions : Financial balance of Korean medicine clinics improved until early 2000, but it became worse in 2007. Though deficits from NHI procedures has been covered up by profit from 'non-insurance medication', health insurance became a major source of income during last two decades.

Suggestion on an Innovative Pulse Diagnosis System based on Technical Trend Analysis (맥진기술동향 조사를 통한 맥진기 개발방안 제안)

  • Lee, Yu-Jung;Lee, Jean;Kim, Jang-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.174-179
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    • 2009
  • Arterial pulse palpation is an important diagnostic method in Oriental Medicine, particularly for obtaining information about a patient's health conditions or illness, or for confirming a diagnostic conclusion based on the patient's pulsation. The pulse analyzer is both a leading Oriental Medical equipment and a promising tool with such a strong industrial ripple effect that it was selected as one of the four strategic tools for world Oriental Medical instrument market domination at a recent survey. Although various pulse analyzers had been developed, however, most of these were not widely used for clinical diagnosis, due perhaps to lack of the appliance's reliability caused by its inability to reflect the requirements of the clinicians. Thus, in this thesis, the clinical requirements for the pulse analyzer were identified and analyzed by conducting a questionnaire survey among Oriental Medicine clinicians. By looking into the basic functions of a pulse analyzer, the required measurement time, and the medical insurance fee required were determined and among others, the appliance's specific requirements were determined. Moreover, by investigating on the latest patent trend, the technical elements that are needed for the development of a next-generation pulse analyzer were identified. Through these processes, the flow of the technology that must be developed for the pulse analyzer was determined, and the direction for the development of the specific pulse analyzer hardware, sensor, and diagnostic algorithm was identified and proposed.

Problems and Potential Improvements of National Health Insurance Fees Associated with Miniscalpel Acupuncture (도침술의 진료수가에 대한 문제점과 개선방안)

  • Oh, Se Jung;Park, Mu Seob;Lee, Jung Hee;Jun, Seung Ah;Gong, Han Mi;Choi, Seong Hun;Hwangbo, Min;Lee, Hyun Jong;Kim, Jae Soo
    • Journal of Acupuncture Research
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    • v.33 no.3
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    • pp.67-73
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    • 2016
  • Objectives : The objective of this study is to discuss problems and potential improvements of national health insurance fees associated with miniscalpel acupuncture according to Korean medical doctors' workload, material cost and degree of risk. Methods : We researched the change of relative value points, national health insurance fees, the acupuncture process, and Korean medicine doctors' workload related to Miniscalpel acupuncture, as compared to general meridian point acupuncture. We also examined material cost by surveying pharmacies, internet shopping malls and medical appliance shops. Results : Relative value point for Miniscalpel acupuncture decreased from 2010 to 2012, and remained the same from 2012 to 2016. National health insurance fees for Miniscalpel acupuncture increased by a small margin annually for rise of equivalent index. There was no reporting on workload related to Miniscalpel acupuncture. Material cost of Miniscalpel acupuncture was 18.2~20.7 times higher than actual cost of procedure. There were few studies examining medical accidents related to Miniscalpel acupuncture, and thus we could not evaluate degree of risk. Conclusion : We suggest revaluating Korean medical doctors' workload related to including Miniscalpel acupuncture, to consider the material costs of Miniscalpel acupuncture, and investigate its degree of risk by researching medical accidents.

KAP Study on Chinese Traditinal Doctor, Hospital and Medicine in China (최근 일부 중국인(中國人)의 중의사(中醫師).중의학(中醫學) 관련 인식(認識).태도(態度) 및 의료행위(醫療行爲)에 관한 연구)

  • Lee, Sun-Dong;Kim, Myung-Dong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.187-198
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    • 1997
  • The degree of KAP study on Chinease traditional medicine and doctor was examined with some chinease living yenbian district(延邊) from July 1st to August 30th in 1996. The result of the study for predicting health and ill patterns runs as fellows. 1. It is understand to strength and variety about role of chinease traditional medicine doctors and the curable disease. 2. Although most patients go to chinease traditional medicine clinic for the purpose of medicine herbs in package, acupuncture and industry-made pharm, they think the medical fee a little high(70.6%). 3. The 66.7% of respondents recognize chinease traditional medicine doctors as a profession and others think them only abundant works ; therefore it is rather low to ink chinease traditional doctors a profession. 4. Most respondents think that chinease traditional medicine should improved in the inside ; such as scientific reinforcement of theory, lack of univerality, improvment and enlargement of insurance, unkindness, shortage of publicity, dropped equipment, system of medical specialist, lack of integration with westem medicine, exact diagnosis and confidence of remedy, and low efficacy, etc. 5. Chinease likes more experienced-traditional doctor than beginner(78.3%) 6. The policy of korean government against 100 herbal prescription right by western pharmacy has taken the negative recognition(74.6%), 7. The degree that acknowleges of chinease traditional medicine through thease basic contents is average 47.3 mark. To be brief, although the step of the recognition and attitude of oriental medicine is less or very affirmative aspect, actully considerable positive factors is in the last chosen step. In conclusion KAP study connected chinease traditional medicine and doctor has very much postive factors.

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