We analyzed the active information of Khammouane provincial in 2001, and adjust the hospital fee models by researcher's formula. The results showed that: In the hospital, when the outcomes is bigger than the incomes without fees, we have to take hospital fees, contrary to, we don't take it. The fees are correct when outcomes are equal or smaller than incomes with fees and exemption payments need to equal or bigger than these incomes without fees, therefore the average fee collection need to equal or bigger than average hospital payment. At Khammouane provincial hospital, in 2001, the correct models of hospital fees are 'collect all of medical services with the cost of 3 factors: salary, administration cost and drugs-consumer equipment'. The correct models of hospital fees can provide the expenditure on health care in the hospital throughout the year, can raise medical service quality and make more the context for the poor patients can use the health care service without the fees.
Hospitals ; Fee-for-Service Plans

The fee-for-service system is used as the main payment system for health care providers in Korea. It has been argued that it can't reflect differences in the medical practice costs across regions because the fee schedule is calculated based on the average cost. So, some researchers and providers have disputed that there is need for adopting geographic practice cost index (GPCI) used in the United States for the Medicare program for the elderly to the fee-for-service payment system. This study performed to identify whether the difference in the practice costs among regions exists or not and to examine the feasibility of applying GPCI to Korea payment system. For this purpose, we calculated modified-GPCI and examined considerations to introduce GPCI in Korea. First we identified available data to calculate GPCI. Second, we made applicable GPCI equations to Korea payment system and computed it based on four types of regions (metropolitan, urban, suburban, and rural). We also categorize the regions based on the availability of the medical resources and the capability of utilizing them. As a result, we found that there wasn't any significant difference in the GPCI by regional types in general, but the indices of rural areas (0.91–0.98) was relatively low compared to the indices of other regions (0.96–1.07). Considering the need to use GPCI floor, the pros and cons of using GPCI, and the concern of the regional imbalance of resources, the introduction of GPCI needs to be carefully considered.
Aged ; Fee Schedules ; Fee-for-Service Plans ; Health Personnel ; Humans ; Korea ; Medicare ; Relative Value Scales ; United States

BACKGROUNDMedical consortium is a specific vertical integration model of regional medical resources. To improve medical resources utilization and control the health insurance costs by fee-for-service plans (FFS), capitation fee and diagnosis-related groups (DRGs), it is important to explore the attitudes of doctors towards the different health insurance payment in the medical consortium in Shanghai.

METHODSA questionnaire survey was carried out randomly on 50 doctors respectively in 3 different levels medical institutes.

RESULTSThe statistical results showed that 90% of doctors in tertiary hospitals had the tendency towards FFS, whereas 78% in secondary hospitals towards DRGs and 84% in community health centers towards capitation fee.

CONCLUSIONSThere are some obvious differences on doctors' attitudes towards health insurance payment in 3 different levels hospitals. Thus, it is feasible that health insurance payment should be supposed to the doctors' attitudes using the bundled payments along with the third-party payment as a supervisor within consortium.

In the last few moments of life before death, a more adequate health care system must be established in order for suffering patients to have their dignity respected. To this point, Korea's health care system does not possess additional health insurance reimbursement covering hospice care. Until recently, the existing fee for service system consists of an informal hospice care service that has been developed and supplied. Due to society's increasing expectation of hospice reimbursement in regard to development and in reality, progression is currently being undertaken which we have welcomed. However, there has been a tendency for over expectation in financial reduction by hospice reimbursement introduction in which there were evidence from cases in other nations. In practice, supplementation of per diem type of hospice coverage will be the mainstream and fee for service in some areas must be explored in order to compensate for the negative aspects of per diem type of hospice coverage.
Delivery of Health Care ; Fee-for-Service Plans ; Hospice Care ; Hospices ; Humans ; Insurance, Health, Reimbursement ; Stress, Psychological

This article overviews currently available options for rewarding peer reviewers. Rewards and incentives may help maintain the quality and integrity of scholarly publications. Publishers around the world implemented a variety of financial and nonfinancial mechanisms for incentivizing their best reviewers. None of these is proved effective on its own. A strategy of combined rewards and credits for the reviewers1 creative contributions seems a workable solution. Opening access to reviews and assigning publication credits to the best reviews is one of the latest achievements of digitization. Reviews, posted on academic networking platforms, such as Publons, add to the transparency of the whole system of peer review. Reviewer credits, properly counted and displayed on individual digital profiles, help distinguish the best contributors, invite them to review and offer responsible editorial posts.
*Communication ; Fee-for-Service Plans ; Humans ; *Peer Review, Research ; Periodicals as Topic ; Publishing ; *Reward ; Science

PURPOSE: The main purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. MATERIAL AND METHODS: A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current payment rates of individual services. RESULTS: The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12- 2.55 times lower in total body irradiation. CONCLUSION: We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.
Classification* ; Fee-for-Service Plans ; Hospital Costs ; Humans ; Radiation Oncology* ; Whole-Body Irradiation

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.
Academies and Institutes ; Fee-for-Service Plans ; Fees and Charges ; Gwangju ; Hospices ; Hospitals, General ; Humans ; Insurance ; Palliative Care ; Reward

Medical insurance, which is mandatory in Korea, has been progressed in the way of expanding the relevant population and intensifying the guarantee. However, rapid increases in medical expenses led national health insurance into a state of financial crisis. The government considered the reason of financial crisis as fee-for-service and started reorganizing the terms of payment from fee-for-service to case-payment. Therefore, an expanded diagnosis related group (DRG) payment system is carried out to decrease the expense on health and to secure financial stability. At the same time, the new case-payment system, apposite to the medical case in Korean society, is under demonstration. DRG payment system is in execution for the 7 disease entities of the four departments requested for now. However, it is supposed to be carried out in all the hospitals from the second half of 2012 and be expanded to all the general hospitals from 2013. The new case-payment system is under development because it is difficult to apply DRG to all disease entities. These shake-ups in the payment system will be conducted from the year 2015, combining both the DRG and new case-payment system. Basically, the introduction of the new case-payment system will cause doctors' passive attitude in the treatment of patients. This would be an especially serious problem for the department of surgery whose charge for operation is very low. It would be worse for the vascular surgeons because only 80% of operational or interventional procedures will be compensated, the fee for ultrasound is included in the new case-payment system, and age-related severity is not reflected in the disease entity. If relaunch is inevitable, vascular surgeons should understand the new case-payment system exactly and point out the problems. Also, standard guidelines on treatment per procedure should be set up and used for the established case-payment system, which would be helpful in reducing unnecessary medical expenses.
Diagnosis-Related Groups ; Fee-for-Service Plans ; Fees and Charges ; Hospitals, General ; Humans ; Insurance ; Korea ; National Health Programs

BACKGROUND AND OBJECTIVES: The Korean National Health Insurance is based on 'fee for service' system, but recently 7 groups of diseases were forcibly applied to diagnosis related groups (DRG) system. In these 7 group of diseases, tonsillectomy and adenoidectomy were included in the otorhinolaryngology field. The objective of this research is to estimate the invested medical costs, profit and loss, and improvement points for the disease groups according to DRG and 'fee for service' system. SUBJECTS AND METHOD: We investigated 1,377 subjects who underwent tonsillectomy and adenoidectomy based on DRG between January 2011 to December 2013 at our hospital. The profit and loss of medical costs were calculated according to medical record data, medical service fee, and activity based costing (ABC). RESULTS: The total of 1,377 subject comprised of 905 patients younger than 17 years-old and 472 patients older than 18 years-old. A main moderate complication that was not one of the DRG diseases, postoperative bleeding, was only found in 19 patients (1.38%). Profit related to tonsillectomy and adenoidectomy studied for a 3 year-period was higher in the DRG system than in the 'fee for service' system; however, profit was reported as 62.9-67.5% of the actual prime costs. CONCLUSION: DRG system for tonsillectomy and adenoidectomy seems to have higher compensation rate than the 'fee for service' system does. However, the system is still insufficient to compare profit with the input medical cost. Furthermore, the present system of disease grouping needs to be improved to reflect actual medical prime costs.
Adenoidectomy* ; Compensation and Redress ; Diagnosis-Related Groups ; Fee-for-Service Plans ; Fees and Charges ; Hemorrhage ; Humans ; Medical Records ; National Health Programs ; Otolaryngology ; Tonsillectomy*

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we divided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be reduced to reduce hospital cost in korea. we thought that the korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the united states. This study presents some limitations such as on insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can possibly affect LOS, However, this study reports an important trend in LOS from 1984 to 1994.
Diagnosis-Related Groups ; Fee-for-Service Plans ; Hospital Bed Capacity ; Hospital Costs ; Hospitals, Public ; Humans ; Internal Medicine ; Korea* ; Length of Stay* ; Ownership ; United States