완화의료 일당정액수가제 시행에 따른 진료비와 진료행태의 변화
= Changes in the Medical Cost and Practice Pattern according to the Implementation of per Diem Payment in Hospice Palliative Care
- 저자[authors] 임문남 , 최성우, 류소연 , 한미아
- 학술지명[periodical name] 보건행정학회지
- 권호사항[Volume/Issue] Vol.29No.1[2019]
- 발행처[publisher] 한국보건행정학회
- 자료유형[Document Type] 학술저널
- 수록면[Pagination] 40-48
- 발행년[Publication Year] 2019
- 주제어[descriptor] Hospices; Per diem payment; Fee-for-service plans; Medical service charge; Medical practices
다국어 초록[Multilingual Abstract] Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.