• 보건행정학회지
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• 제30권3호
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• pp.409-417
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• 2020

Background: It is well known that the distribution of therapeutic materials is very complex. However, it is not easy to demonstrate the concrete problems caused by distribution channels empirically. The purpose of this study was to investigate the differences in the price of therapeutic materials according to the type of purchasing agency and the way in which medical institutions purchase therapeutic materials. Methods: This study compared the claimed prices and the maximum allowable prices for the items of therapeutic material used for general spinal surgery. Results: Ilsan Hospital, which purchased directly without a purchasing agent, had the lowest claimed prices, followed by a large professional purchasing agency, a foundation-related purchasing agency, and a general purchasing agency. In addition, the difference between the claimed prices and the maximum allowable prices according to the purchase type was larger in the expensive treatment materials, and in the case of the lower price treatment materials, it tended to converge to the maximum allowable prices. Conclusion: National health insurance spending for therapeutic materials are to be affected by the distribution channels of them. We proposed several ideas to rationalize the expenditure such as classification of therapeutic materials on the basis of price or other criteria.

• 한국산학기술학회논문지
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• 제12권2호
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• pp.646-652
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• 2011

전 세계적으로 개인의 건강에 대해서 관심이 커져가고 있다. 이에 따라 개인의 건강과 관련이 높은 보험산업의 중요성이 높아지고 있다. 보험산업은 크게 생명보험산업과 손해보험산업으로 구분 할 수 있다. 따라서 본 연구에서는 생명보험산업과 손해보험산업에 대하여 산업연관분석을 이용하여 국민경제적 파급효과를 비교 분석하여 보고자 한다. 분석에서는 외생화기법을 사용하여 생산유발효과, 부가가치 유발효과, 취업유발효과, 물가파급효과를 분석한다. 분석결과는 손해보험산업의 생산유발효과는 2.7원, 부가가치 유발효과는 1.6원, 취업유발효과는 26.9명, 물가파급효과는 2.0%로 분석되었다. 반면 생명보험산업의 생산유발효과는 1.6원, 부가가치 유발효과는 1.0원, 취업유발효과는 16.5명, 물가파급효과는 1.2%로 분석되었다. 종합적으로 보면 손해보험산업이 생명보험산업의 파급효과보다 높은 것으로 나타났다.

• Journal of Preventive Medicine and Public Health
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• 제22권3호
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• pp.398-405
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• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• 대한예방한의학회지
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• 제23권2호
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• pp.43-51
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• 2019

Objectives : This study aimed to analyze price variance by year, region and company of raw herbal medicines to draw payment system for herbal medicine insurances in the National Health Insurance. Methods : To analyse price variance, we used 2015-2017 data of 'Quality test results of imported herbal medicines' provided by Korea Pharmaceutical Traders Association and 'Price data of 56 raw herbal medicines' that was surveyed by the Association of Korean Medicine. We analysed gap of highest price and lowest price those were compared with average price and coefficient of variation(CV) of prices by year, region and company of raw herbal medicines. Results : In analysing 3 years data, the highest price was 23.2% higher, and the lowest price was 19.1% lower than the average price. As of 2018, the average price of domestic produced herbal medicines was 1,8 times higher than that of imported herbal medicines. By companies, the highest price was 117.5% higher, and the lowest price was 57.3% lower than the average price. Conclusions : The price of herbal medicines varied by production year, region and company. This results suggest that comprehensive payment model needs to be considered in modeling the health insurance coverage for herbal medicine decoctions.

• 한국병원경영학회지
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• 제8권1호
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• pp.1-23
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• 2003

General drug prices involve three stages: shipment stage, wholesaler stage and retail stage. Policies on drug price differ from country to country. Shipment stage prices are tightly regulated in countries like France and Netherlands. They are free in only a minority of advanced countries, even if these include some major players such as the US, Germany and, in a very limited sense, Japan. The situation in the UK is very complex with a semi-free system, where drug companies are free to set their own prices but cannot exceed a predetermined profit ceiling. Mark-up at both wholesaler and retail stages is formally admitted in most countries observed. Apart from the general drug prices, reimbursement price of insured drugs has been major policy concerns. Most countries reviewed in this study has exerted some control over reimbursement prices, but differ both in the way how and in the extent to which prices are admitted or fixed. Price fixing has been used in France and Japan. Some countries have transformed their system over time, particularly to move to reference pricing in the last decade. This mechanism has empowered the customer, and improved price competition on the market. Referring to the drug price policies in the advanced countries, this study makes some suggestions for the redirection of Korean price policy for reimbursement drug in health insurance as follows: to match appropriate policy tools to each policy goal; to maximize market mechanism through effective reimbursement price fixing which admits mark-ups in wholesaler and retail prices; to introduce reference pricing system in order to redirect patient's demand with a financial incentive to choose the best-priced drugs and to save the finance of health insurance; and to strengthen surveillance and monitoring mechanism in the drug market.

• 보건행정학회지
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• 제15권3호
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• pp.40-59
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• 2005

The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer's financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by $1.53\%$ on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer's financial situation given that the current compulsory separation between doctor's prescribing and pharmacist's dispensing is irrevocable.

• 한국산학기술학회논문지
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• 제7권2호
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• pp.231-237
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• 2006

2006년 3 월부터 보건복지부에서는 비급여 항목으로 환자의 부담이 컸던 환자식을 급여화하기로 함에 따라 입원환자에 제공하는 병원에서 제공하는 환자식 가격과 관련한 논란이 심화되고 있다. 본 연구는 과학적 방법으로 병원 모집단을 층화 추출한 후 71 개라는 많은 병원 자료를 이용해 급식 유형별 원가와 적정가격을 산정한 우리나라 최초의 연구이다. 활동원가계산과 상대가치 개념을 사용해 급식 유형별 원가를 산출 한 후, 급식 유형별 원가에 영향을 미치는 변수를 알아보았다. 환자식 가격에 영향을 미치는 가장 의미있는 변수는 급식종사인력과 급식 수이므로 보험수가에서는 이들 변수를 고려하여야 한다.

• 대한예방한의학회지
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• 제13권3호
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• pp.113-126
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• 2009

Objective : This research aimed to investigate and analyze the opinions of Oriental Medical Doctors (O.M.D.) on covering herbal medicines into National Health Insurance scheme. Methods : Structured questionnaires were e-mailed to the O.M.D.s listed on member's DB of the Association of Korean Oriental Medicine. Collected data were analyzed with the SPSS 12.0 program. Results : The insurance coverage for herbal decoctions was supported by 80.8% of the responders, the median reasonable price for daily herbal decoctions was \9,517, the minimum price median of daily herbal decoctions considering its costs was \8,080, and the daily technical fee median was \4,379. On health insurance coverage for herbal decoctions, O.M.D.s were specially considering the standardization of herbal medicines. Conclusion : In this study, majority of O.M.D.s assented to health insurance coverage for herbal decoctions, but considered standardization of herbal medicines and optional prescription fee. It needs to prepare plan for insurance coverage of herbal decoctions that reflect the character of oriental medicine and oriental medical institutions.

• 보건행정학회지
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• 제28권4호
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• pp.360-368
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• 2018

Background: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. Methods: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. Results: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. Conclusion: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.

• Journal of the Korean Data and Information Science Society
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• 제17권2호
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• pp.355-366
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• 2006

Customer Satisfaction (CS) in Auto insurance market is the important factor which makes customer loyalty and retention increase. Recently On-line companies are threatening the existing Off-line companies with taking advantage of the low price through cut-offing the price by internet marketing. Therefore, the CS is becoming an indispensable survival strategy to the Off-line companies. Under these circumstances, this study finds out what the CS factors are in the auto insurance market, and produces levels of CS, customer loyalty and satisfaction Index of each category. The purpose of this study is to suggest the strategic improvement factor for elevating CS level and strategic direction for CS management by CS portfolio analysis based on the survey result.