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발행년 : 2008 
구분 : 국내학술지 
학술지명 : 대한예방한의학회지(The Journal of Oriental Medical Preventive) 
관련링크 : http://www.riss.kr/link?id=A100683028 
한방의료서비스의 건강보험수가 산출방법과 추정
= Estimating the Reimbursing Price Level of Oriental Medical Services in the National Health Insurance

                                    

  • 저자명

    김진현                                                                 

  • 학술지명

    대한예방한의학회지(The Journal of Oriental Medical Preventive)                           

  • 권호사항

    Vol.12 No.3 [2008]                                                           

  • 발행처

    대한예방한의학회                                  

  • 자료유형

    학술저널

  • 수록면

    21-34(14쪽)

  • 언어

    Korean

  • 발행년도

    2008년

초록 (Abstract)

  • Objectives : This paper analysed the alternative methods of calculating conversion factor for oriental medicine in the National Health Insurance and estimated the conversion factor(reimbursing price level) of the oriental medical services, based on he...
  • Objectives : This paper analysed the alternative methods of calculating conversion factor for oriental medicine in the National Health Insurance and estimated the conversion factor(reimbursing price level) of the oriental medical services, based on health insurance claims data and macro economic data. Methods : Comparing cost accounting method, SGR model, and index model to estimate conversion factor in the national health insurance, six empirical models were derived depending on the scope of revenue considered in financial indicators. Classifications of data and sources used in the analysis were identified as officially released by the government. Results and Conclusion : Cost accounting analysis and SGR model showed a two digit decrease in the physician fee schedule of oriental medical services in the national health insurance, while index model indicated a positive increase in the fee reimbursed. As expected, SGR model measured an overall trend of health expenditures rather than an individual financial status of medical institutions, and index model properly estimated the level of payments to oriental medical doctors. Upon a declining share of health expenditures on oriental medicine, a global budget system fixed to a flat rate of total budget could be an opportunity as well as a challenge.
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