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| 발행년 : | 2018 |
|---|---|
| 구분 : | 국내학술지 |
| 학술지명 : | 대한내과학회지 |
| 관련링크 : | http://www.riss.kr/link?id=A105247975 |
보험수가 결정과 건강보험 보장성 강화 대책
= Determination of Health Insurance Fee Schedule and Strengthening Policy for Health Insurance Coverage
- 저자[authors] 김영삼 ( Young Sam Kim )
- 학술지명[periodical name] 대한내과학회지
- 권호사항[Volume/Issue] Vol.93No.2[2018]
- 발행처[publisher] 대한내과학회
- 자료유형[Document Type] 학술저널
- 수록면[Pagination] 80-86
- 언어[language] Korean
- 발행년[Publication Year] 2018
- 주제어[descriptor] 보험수가, 의료보험 보장성 강화, 자원기준 상대가치, Health insurance reimbursement, Insurance beneficiary, Resource based relative value scale (RBRVS)
초록[abstracts]
[The resource-based relative value scale (RBRVS) was introduced in Korea as a payment system in 2001. However, the health insurance fee schedule had many problems. Unbalanced insurance fee schedules still occur, and the relative value was not divided between physicians’ work and practice expenses. Furthermore, malpractice fees were not included in the total RBRVS. The first refinement project of the health insurance relative value scales was conducted in 2003 and the second project started in 2010. In the first project, final relative values were calculated under budget neutrality by medical departments, and imbalances within the departments were resolved. However, imbalances still existed between departments. In the second project, final relative values were classified and computed by the type of medical treatment. The final RBRVS has been applied step by step since 2017 and the imbalance problem of the insurance fee schedule has been partially resolved. The government recently announced strengthening the plan for health insurance coverage. The current coverage rate for total medical costs by national health insurance is 63%. The purpose of this plan was to increase the coverage rate by up to 70%. The government has suggested detailed plans but there remain many controversial issues and limitations with regard to the practical aspects. Thus, further research and suggestions are needed. (Korean J Med 2018;93:80-86)]
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