|000||00911namccc200217 k 4500|
|008||041127s2004 ulka m AC 000a kor|
|040||▼a 211009 ▼d 211009|
|085||▼a 0510 ▼2 KDCP|
|090||▼a 0510 ▼b 6H3 ▼c 30|
|245||1 0||▼a 포괄수가제 시범사업 전,후 질식분만 환자의 진료형태 변화에 관한 연구 : ▼b 보험자 직영 병원을 중심으로 = ▼x (A)study on medical practices of vaginal delivery before or after DRGs payment system / ▼d 鄭雨錫.|
|260||▼a 서울 : ▼b 고려대학교 , ▼c 2004.|
|300||▼a ⅵ, 52 p : ▼b 삽도 ; ▼c 26 cm.|
|500||▼a 지도교수 : 윤석준|
|502||0||▼a 학위논문(석사) -- ▼b 고려대학교 보건대학원 : ▼c 보건정책 및 병원관리학과 , ▼d 2004.8|
|653||▼a 포괄수가제 ▼a 행위별수가제 ▼a 질식분만 ▼a 진료비 ▼a DRG ▼a Diagnosis Related Group ▼a FFS ▼a Fee for Service ▼a Vaginal delivery ▼a medical fee|
|900||▼a Jeong, Wo Seok|
A study of medical treatment practices of vaginal delivery before and after application of DRGs payment system. This study was designed to analyze factors, medical service practices and medical fee differences which influence the amount of medical services and medical fees when applying a Fee For Service system rather than a Diagnosis Related Group payment system. The subjects were 178 patients who were hospitalized and underwent vaginal delivery. Half (89) fell under DRG, and the other half (89) fell under FFS. By using all the data, including medical treatment fee statements, bills, and patient medical charts, we obtained the following results: First, there was a big gap between the DRG patients and the FFS patients. Second, medical treatment revenues increased when FFS was applied compared to DRG. Third, there was an increase in patients medical fees, including the fees that were not covered by medical insurance, when DRG was applied. Fourth, there was a decrease in patients medical fees that were not covered when DRG was applied. In conclusion, when FFS was applied to the patients who underwent vaginal delivery without complications, the number of hospitalization days, medical fees, and patients medical co-payments, including fees not covered by medical insurance, had increased, which led to an increase in hospitals revenues. From now on, there should be more studies on changes in the seven objects which were applied to DRG and all the hospitals which were applied to DRGs payment system. In addition, individual patient characteristics (such as occupation, educational level, and financial situation) and doctor's diagnosis types should also be considered. Finally, diverse approaches should be undertaken to improve patient care quality, enhance hospital medical revenues and reduce medical treatment costs.
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