한방물리요법 상대가치 산출과 급여 확대 시 재정부담 추계

Measuring the resource-based relative value scale scores for physical therapies of traditional Korean medicine and estimating the insurer's expenditure in National Health Insurance

  • 임병묵 (부산대학교 한의학전문대학원 인문사회의학부) ;
  • 신미숙 (부산대학교 한의학전문대학원 한방재활의학과) ;
  • 신병철 (부산대학교 한의학전문대학원 한방재활의학과) ;
  • 송윤경 (경원대학교 한의과대학 한방재활의학과) ;
  • 송미연 (경희대학교 한의과대학 한방재활의학과) ;
  • 신승우 (강남청구경희한의원) ;
  • 김호준 (동국대학교 한의과대학 한방재활의학과) ;
  • 이명종 (동국대학교 한의과대학 한방재활의학과)
  • Lim, Byung-Mook (Division of Humanities and Social Medicine, School of Korean Medicine, Pusan National University) ;
  • Shin, Mi-Sook (Department of Oriental Rehabilitation Medicine, School of Korean Medicine, Pusan National University) ;
  • Shin, Byung-Cheul (Department of Oriental Rehabilitation Medicine, School of Korean Medicine, Pusan National University) ;
  • Song, Yoon-Kyung (Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Kyungwon University) ;
  • Song, Mi-Yeon (Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Kyung Hee University) ;
  • Shin, Seung-Woo (Gangnam Cheonggu Kyung Hee Oriental Clinic) ;
  • Kim, Ho-Jun (Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dongguk University) ;
  • Lee, Myeong-Jong (Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dongguk University)
  • 투고 : 2010.08.10
  • 심사 : 2010.08.25
  • 발행 : 2010.08.31

초록

Backgrounds : Since December 1, 2009, National Health Insurance began to reimburse for three physical therapies of Korean medicine. The extension of insurance coverage is demanded by Korean medicine societies. Objectives : This study aimed to measure the resource-based relative value scale (RBRVS) scores for thirty four physical therapies of Korean medicine and to estimate the insurer's expenditure for them in National Health Insurance. Methods : To measure the physician's work and the practice expense, the 'magnitude estimation method (MEM)' and the 'fully distributed cost - attributable cost method (FDC-ACM)' were applied respectively. We collected the frequency data of physical therapies from Korean medicine hospitals and clinics to estimate the total expenditure. Results : The resource-based relative value scale scores of physical therapies were measured from 23.44 to 160.66. Total insurer's expenditure was calculated to be 95.5 billion won as of 2009. Conclusions : Based on the result that showed minor increase of total expenditure, most physical therapies of Korean medicine need to be reimbursed in the National Health Insurance.

키워드

참고문헌

  1. 한방재활의학과학회. 한방재활의학. 2005.
  2. 메디컬투데이. 한방물리요법, 12월부터 보험급여 적용. 2009. 11. 28.(http://www.mdtoday.co.kr)
  3. 신미숙, 신병철, 이명종, 김호준, 송윤경, 송미연, 신승우, 임병묵. 한의원의 한방물리요법이용 현황과 건강보험 급여화에 대한 인식.한방재활의학과학회지. 2009 ; 19(3) : 101-10.
  4. 이윤태, 박종애, 강대욱, 박재산, 박수범, 엄미정. 한의원 경영수지 분석(5차) 연구. 한국보건산업진흥원. 2008.
  5. 국민건강보험공단. 건강보험요양급여비용. 2009.
  6. 양봉민, 김진현, 임병묵, 정현진, 오현주, 천동환, 서동민, 박은하. 한방의료의 상대가치 체계 연구. 대한한의사협회. 2002.
  7. 임병묵, 김진현, 장인수, 한창호, 민지현, 양진욱. 한의표준의료행위에 대한 상대가치 개발. 대한한의사협회. 2003.
  8. 김진현, 임병묵. 한방의료서비스의 건강보험 상대가치체계 개편방안. 대한한의학회지. 2005 ; 26(2) : 105-125.
  9. 임병묵, 권혁상, 한창호, 신병철. 계층화 분석법(Analytic Hierarchy Process)을 활용한 한의사 업무량 산출. 2009 ; 13(1) : 105-115.
  10. 양봉민, 김진현, 이태진, 김윤희, 김정희, 최숙자. 건강보험의 목표보장률 설정 및 실현방안에 관한 연구. 서울대학교 보건대학원.2006.