Article Detail

Home > Article Detail
  • P-ISSN 1010-0695
  • E-ISSN 2288-3339

Comparative Analysis Study of Oriental and Western Medical Insurance Fees in Long-Term Care Hospitals

Journal of Korean Medicine / Journal of Korean Medicine, (P)1010-0695; (E)2288-3339
2013, v.34 no.1, pp.35-51



  • Downloaded
  • Viewed

Abstract

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.

keywords
Oriental medical insurance fee, long-term care hospital, total medical expenses, co-pay


Reference

1

1. Choi YH. Time series comparison of health utilization and medical cost of 19 geriatric disease in Korea. Seoul : Konkuk Univ.; 2010.

2

2. Lee JW, Seomun JH. A study on problems and improvement of home-help service of long-term care insurance. Kor. J. Gerontological Society. 2009;29(1):149-75.

3

3. 이중규. 요양병원형 일당정액수가제의 도입과전망. HIRA 정책동향 2007;1(3):6-7.

4

4. 이광재. 노인장기요양보험제도 정책과정의 이해.경기:공동체. 2010:27-30.

5

5. 선우덕, 김찬우, 임효연, 김순옥, 서동민, 양영애,등. 최신 노인 장기요양보험제도 현황과 과제. 서울:주식회사 노인연구정보센터. 2012:76-91.

6

6. Seok JE. Unit costs of care services in long-term care insurance in korea; its characteristics and evaluation. Kor. J. Social Welfare Studies. 2008; 39:253-286.

7

7. Lee JY, Yoon JY, Kim JH. Song SH, Joo JS, Kim EK. Development of patient classification system in long-term care hospitals. Kor. J. Acad Nurs Admin. 2008;14(3):229-40.

8

8. Han ST, Kang HC, Choi BS, Lee SK. A study on the judgement rating for level of need for long-term care insurance using a decision tree. Kor. J. Statistical Society. 2011;18(1):137-146.

9

9. 장재혁, 박정배, 최영호, 손일룡, 김일열, 고치범등. 노인장기요양보험의 이해. 서울:도서출판 들샘. 2010:319-25.

10

10. 국민건강보험공단. 노인장기요양보험 법령집.서울:도서출판 들샘. 2008:61-2.

11

11. Won HJ. Trend of changes in medical expenses of the elderly in long-term care hospitals. Busan: Inje Univ.; 2010.

12

12. Kim SW. A study on the business management in the nursing facilities by oriental therapy and remedies. Gyeongsan : Daegu Haany Univ.; 2010.

13

13. 김동환, 김명화, 황진영. 요양병원 진료비 증가요인; 건강보험 입원진료비 중심으로. 서울:건강보험심사평가원. 2010:9-10,44-6.

14

14. Jeiung YS. A study on the problem sand the effective operating plans of long-term care hospitals in Korea. Jeonju : Jeonju Univ.; 2011.

15

15. Kim YB. A study on evaluation and improvement of long-term care hospitals for changing long-term care hospital fee system. Kor. J. Health Service Management. 2011; 5(2):105-17.

16

16. Sun WD, Lee SH, Lyu KC, Son CK, Shin HS, Choi Y, et al. A study on the improvement of long-term care system for the elderly. Seoul:KIHASA. 2008:72-110.

17

17. 가혁. 노인요양병원 진료 지침서. 서울:군자출판사. 2011:13-4.

18

18. 송현종, 채정미, 이병란, 이경민. 요양병원의 효율적 관리방안. 서울:건강보험심사평가원 심사평가연구소. 2011:90-103.

19

19. Choi MS. A study on the changes of Korean Medical Health Insurance and the way for improvement of Insurance benefits in the oriental medicine ob&cy disease group: focusing on acupuncture benefits. Seoul : Dongguk Univ.;2008.

20

20. Lim BM, Shin MS, Shin BC, Song YK, Song MY, Shin SW. Measuring the resource-based relative value scale scores for physical therapies of traditional Korean medicine and estimating the insurer's expenditure in National Health Insurance. Kor. J. Oriental Preventive Medical Society. 2010;14(2):57-66.

상단으로 이동

Journal of Korean Medicine