• Title/Summary/Keyword: Resource-based relative value

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Development of a Resource-based Relative Value Scale and Its Conversion Factor for Advanced Nursing Practices in the National Health Insurance (중환자 전문간호행위에 대한 건강보험 상대가치 및 환산지수 개발)

  • Kim, Jin-Hyun;Kim, Myung-Ae;Kim, Mi-Won;Kim, Kyung-Sook;Yoo, Cheong-Suk
    • Journal of Korean Academy of Nursing
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    • v.41 no.3
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    • pp.302-312
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    • 2011
  • Purpose: The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units. Methods: The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed. Results: Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%. Conclusion: Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.

Methods and Applications to estimate the Conversion Factor of Resource-based Relative Value Scale for Nurse-Midwife's Delivery Service in the National Health Insurance (조산원(助産院)의 분만간호서비스에 대한 건강보험수가 산출방법과 적용방안)

  • Kim, Jin-Hyun;Jung, Yoo-Mi
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.574-583
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    • 2009
  • Purpose: This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. Methods: A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. Results: The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Conclusion: Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

A Comparative Study on the Human Resource Efficiency between the Korean and Japanese Municipal Hospitals using Data Envelopment Analysis (DEA를 이용한 한국과 일본 공공병원의 인적자원 효율성 평가)

  • Nam, Sang-Yo
    • Korea Journal of Hospital Management
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    • v.12 no.1
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    • pp.51-74
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    • 2007
  • This study applied Data Envelopment Analysis to a set of Korean Public Corporation Medical Centers and Japanese Municipal Hospitals to compare their relative human resource efficiencies. Based on the data provided on the inputs and outputs, the analysis showed Japanese municipal hospitals were relatively efficient than Korean hospitals. The result of analysing BCC model shows 5 hospitals in Japan and 7 in Korea with an efficiency rating of less than 1 as considered relatively inefficient. For the inefficient hospitals the manner in which inefficient hospitals may be made efficient were indicated by the managerial strategies based on dual variables. A subsequent analysis of Wilcoxon rank-sum test revealed that the medical revenue per medical expense, labor cost per value added revenue were statistically significant between efficient and inefficient Korean hospitals and medical revenue per medical expense, labor cost per value added revenue, bed occupancy rate, average length of stay, rate of personnel expenses per medical revenue were statistically significant between efficient and inefficient Japanese hospitals.

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Comparison of Relative Value on Physician Payment Schedule for reimbursement of health insurance between Korea and U.S.A. (한국과 미국의 기술료에 대한 상대가치 비교)

  • 김한중;조우현;손명세;박은철
    • 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.

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A Study of Human Resource Efficiency in Public Corporation Medical Centers (지방공사의료원의 인적자원 효율성평가)

  • 남상요
    • Health Policy and Management
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    • v.10 no.4
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    • pp.75-98
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    • 2000
  • This study applied Data Envelopment Analysis(DEA) and Ratio Analysis and Regression Analysis to a set of Korean Public Corporation Medical Centers to evaluate their relative human resource efficiencies. The output measure used in this study was based on health insurance system which was used in both in-patient departments and out-patient departments. Inputs included working time of the doctors, nurses, technicians, and managerial department staff. Based on the data provided on the inputs and outputs, the analysis showed 23 of the 34 hospitals to be relatively inefficient. Each hospital with an efficiency rating of less than 1 was considered relatively inefficient. In addition, managerial strategies based on dual variables were constructed to indicate the manner In which inefficient hospitals may be made efficient. A subsequent analysis of t-test revealed that the bed occupancy rate, medical revenue per 100beds, value added revenue per staff, medical revenue per staff were statistically significant. The results of this study suggest the DEA is a promising tool for evaluating relative human resource efficiency in hospitals which have multiple inputs and outputs and where the efficient production function is not specifiable with any precision. But it is considered that efficiency evaluations may be most effective]y accomplished by Incorporating a combination of methodologies such as ratio analysis and regression analysis.

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Economic value evaluation of operating reserve based on opportunity cost (기회비용에 의한 운전예비력의 경제적 가치 평가)

  • Yoon, Yong-Beum;Lee, Jae-Gul;Ahn, Nam-Sung
    • Proceedings of the KIEE Conference
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    • 2005.07a
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    • pp.751-753
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    • 2005
  • In this raper, Economic value of reserve margin i.i presented by opportunity cost for Korean power system, and the level of compensation for spinning reserve that is necessary to operate power system stably is proposed. The generator that is giving up for opportunity to participate in energy market must take opportunity cost. it is relative to not only whole demand level but also marginal cost of each resource. In this paper, assume that all resource in Korea is equivalent to six generator for simulation. and we evaluate value of reserve in the time of high demand and low demand. Also we propose the way to improve a evaluation method by examine relationship between capacity payment and value of reserve.

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Measurement of Physician's Work for Korean Medicine Services Using Analytic Hierarchy Process (계층화 분석법(Analytic Hierarchy Process)을 활용한 한의사 업무량 산출)

  • Lim, Byung-Mook;Kwon, Hyuk-Sang;Han, Chang-Ho;Shin, Byung-Cheul
    • Journal of Society of Preventive Korean Medicine
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    • v.13 no.1
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    • pp.105-115
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    • 2009
  • Background: The resource-based relative value scale has been applied to Korean medicine services as part of the National Health Insurance, yet the proper scoring method for physician's work needs to be developed. Objectives: To measure physician's work for Korean medicine services using Analytical Hierarchy Process(AHP) and to compare results abstracted by AHP with those by Magnitude Estimation method. Methods: We developed the AHP questionnaires for Korean Medicine services and administered it to 12 Korean medicine insurance experts. Weighted scores were calculated and were converted into physician's work scores. Results: In AHP measurement, the physician's work scores for acupuncture activities, especially special acupunctures, far increased, while those for diagnosis and basic consultations decreased. Variations in the scores enlarged. Conclusions: As an alternative, AHP method can be considered for measuring the physician's work for Korean medicine services with careful management of scoring variation.

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Analysis of Clear Sky Index Defined by Various Ways Using Solar Resource Map Based on Chollian Satellite Imagery (천리안 위성 영상 기반 태양자원지도를 활용한 다양한 정의에서의 청천지수 특성 분석)

  • Kim, Chang Ki;Kim, Hyun-Goo;Kang, Yong-Heack;Yun, Chang-Yeol
    • Journal of the Korean Solar Energy Society
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    • v.39 no.3
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    • pp.47-57
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    • 2019
  • Clear sky indices were estimated by various ways based on in-situ observation and satellite-derived solar irradiance. In principle, clear sky index defined by clear sky solar irradiance indicates the impacts of cloud on the incoming solar irradiance. However, clear sky index widely used in energy sciences is formulated by extraterrestrial irradiance, which implies the extinction of solar irradiance due to mainly aerosol, water vapor and clouds drops. This study examined the relative difference of clear sky indices and then major characteristics of clear sky irradiance when sky is clear are investigated. Clear sky is defined when clear sky index based on clear sky irradiance is higher than 0.9. In contrast, clear sky index defined by extraterrestrial irradiance is distributed between 0.4 and 0.8. When aerosol optical depth and air mass coefficient are relative larger, solar irradiance is lower due to enhanced extinction, which leads to the lower value of clear sky index defined by extraterrestrial irradiance.

Deducing Improvement Schemes for Public Medical Centers through Annual Progress Analysis (공공의료기관의 효율성 개선방안에 대한 연도별 추이분석)

  • Kim, Yong-Tea;Kim, Yang-Kyun
    • Journal of Korean Society for Quality Management
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    • v.37 no.3
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    • pp.123-139
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    • 2009
  • This study examines the relative efficiency of 34 local public medical centers in Korea. In order to concretely grasp the causes of inefficiency and suggest improvement solutions, the desirable set point was established based on the actual value which needs to be improved. As a result of analysis, we determined that output must be increased while input is held constant in order to improve effectiveness through the actual value and set point. Efficiency cannot be achieved if input is augmented solely to increase output. Also, to increase output, the medical centers need to improve their quality without increasing any input for customer visits and hospitalizations. Further, in order to strategically promote effectiveness and efficiency of local public medical centers, these medical centers must focus on input resource and patient interchange through the mutual cooperation with local private hospitals and university medical centers.

An Alternative RBRVS System for Oriental Medical Services in the Korean National Health Insurance (한방의료서비스의 건강보험 상대가치체계 개편방안)

  • Kim Jin-Hyun;Lim Byung-Mook
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.105-125
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    • 2005
  • Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.

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