자동차보험과 건강보험의 의료기관 종별가산율 일원화 논리에 대한 고찰
분야
사회과학 > 경영학
저자
김정덕 ( Jung Duck Kim ) , 정은욱 ( Eun Wook Jeong ) , 이종훈 ( Jong Hoon Lee )
발행기관
경희대학교 경영연구원
간행물정보
의료경영학연구 2012년, 제6권 제4호, 25~35페이지(총11페이지)
파일형식
2p900088.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Government has driven the unification of added-ratio by size of medical institution(below ``added-ratio``) between National Health Insurance(NHI) and Traffic Accident Insurance(TAI). And Some studies have supported the policy through arguing that length of stay(LOS) and medical expenditure per hospitalization care of TAI is longer or higher than that of NHI. There is added-ratio difference in tertiary hospital(TAI 15%p higher than NHI), general hospital(TAI 12%p higher than NHI) among medical institutions between NHI and TAI(below ``group A``). But there is no difference in hospital(TAI 1%p higher than NHI), clinic(TAI=NHI)(below ``group B``). The policy target for the unification of added-ratio is group A. But LOS and medical expenditure per hospitalization care(MEPC) of group A is very short in realty. And management strategy of group A is not MEPC but medical expenditure per day(MEPD). To compare 3 medical institutions(general hospital, hospital, clinic) with LOS and MEPC according to same ICD code between NHI`s inpatients and TAI`s inpatients. 3 general hospitals, 3 hospitals, 3 clinics. Treatment amount of 6 months for each medical institutions. TAI`s LOS and MEPC of General hospital is shorter than that of NHI. But THI`s LOS and MEPC of hospital and clinic is longer than that of NHI. TAI`s LOS and MEPC of Group A is shorter than that of NHI. But TAI`s LOS and MEPC of group B is longer than that of NHI.
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