Changes in the Medical Cost and Practice Pattern according to the Implementation of per Diem Payment in Hospice Palliative Care
10.4332/KJHPA.2019.29.1.40
- Author:
Mun Nam LIM
1
;
Seong Woo CHOI
;
So Yeon RYU
;
Mi Ah HAN
Author Information
1. Department of Public Health, Chosun University Graduate School of Health Science, Gwangju, Korea.
- Publication Type:Original Article
- Keywords:
Hospices;
Per diem payment;
Fee-for-service plans;
Medical service charge;
Medical practices
- MeSH:
Academies and Institutes;
Fee-for-Service Plans;
Fees and Charges;
Gwangju;
Hospices;
Hospitals, General;
Humans;
Insurance;
Palliative Care;
Reward
- From:Health Policy and Management
2019;29(1):40-48
- CountryRepublic of Korea
- Language:Korean
-
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.
