An Analysis of Medical Expenses for In-patients in an Oriental Medical Hospital and Factors Affecting Them

한방병원 입원환자의 진료비와 이에 영향을 미치는 요인 분석

  • 고민석 (우석대학교 보건복지대학) ;
  • 최준영 (원광대학교 사회과학대학)
  • Received : 2011.03.18
  • Accepted : 2011.04.26
  • Published : 2011.04.30

Abstract

Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.

Keywords

References

  1. 최만규, 이석민. 한방병원 입원환자의 진료비 특성분석. 한국노년학. 2001 ; 21(1) : 47-57.
  2. 김용복. 한방병원 입원환자의 진료경향 분석. 대전대학교 보건스포츠대학원 석사학위논문. 2003.
  3. 건강보험공단. 2010년 건강보험 주요통계. 2011.
  4. 이호정, 김경성, 박상준. 한방병원 유형화 분석. 한국항공경영학회지. 2009 ; 7(3) : 137-146.
  5. 김지형, 하호욱, 이해종, 손태용. 종합병원 수익성에 미치는 영향요인 분석. 병원경영학회지. 2005 ; 10(3) : 45-66.
  6. 이윤석. 병원의 수익성 관련요인. 연세대학교 대학원 박사학위논문. 2002.
  7. 류정걸. 진료비관리와 심사시스템. 보건복지 연구 논집. 2006 ; 3(1) : 103-108.
  8. 박용억. 한방병원 입원환자의 의료재이용 결정요인에 관한 연구. 대한보건협회학술지. 2000 ; 26(3) : 317-324.
  9. 이한울, 정명수, 이기남. 계층별 한방의료 이용 실태에 관한 연구. 대한예방한의학회지. 2007 ; 11(2) : 71-86.
  10. Rich MW, Vinson JM, Sperry JC, Shah AS, Spinner LR, Chung MK and Davila- Roman V. Prevention of readmission in elderly patients with congestive heart failure : Results of a prospective, randomized pilot study. Journal of General Internal Medicine. 1993 ; 8 : 585-590. https://doi.org/10.1007/BF02599709
  11. Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE and Carney RM. A multidisciplinary intervention to prevent the re-admission of elderly patients with congestive heart failure. New England Journal of Medicine. 1995 ; 333 : 1190-1195. https://doi.org/10.1056/NEJM199511023331806
  12. Naylor M, Brooten JD, Jones R, Lavizzo-Mourey R, Mezey M and Pauly M. Comprehensive discharge planning for the hospitalized elderly. Annals of Internal Medicine. 1994 ; 120 : 999-1006. https://doi.org/10.7326/0003-4819-120-12-199406150-00005
  13. 신종연, 김옥남. K-DRG 대상환자의 진료행태와 진료비 분석에 관한 연구. 병원경영연구소 논문집. 1997 ; 3(1) : 1-17.
  14. Olin JW, Beusterien KM, Childs MB, Seavey C, McHugh L and Griffiths RI. Medical costs of treating venous stasis ulcers : evidence from a retrospective cohort study. Vascular Medicine. 1999 ; 4(1) : 1-7.
  15. Wagner TH, Chen S and Barnett PG. Using Average Cost Methods to Estimate Encounter-Level Costs for Medical-Surgical Stays in the VA. Medical Care Research and Review. 2003 ; 60(3) : 15s-36s. https://doi.org/10.1177/1077558703256485
  16. 김명중. 음주관련 질병의 진료비 지출 현황. 인제대학교 보건대학원 석사학위논문. 2003.
  17. Nietert PJ, French MT, Kirchner JE and Booth BM. Utilization and Cost of Mental Health, Substance Abuse, and Medical Services among At-Risk Drinkers. Medical Care Research and Review. 2007 ; 64(4) : 431-448. https://doi.org/10.1177/1077558707301962
  18. Jayadevappa R, Chhatre S and Weiner M. Gastro-oesophageal acid-related disease, co-morbidity and medical care cost. Chronic Illness. 2008 ; 4 : 209-218. https://doi.org/10.1177/1742395308092817
  19. 전기홍, 이관우, 김대중, 김혜진, 백경원, 이수진. 일개 대학병원의 당뇨병환자들의 진료비 분석(1996-2005). 대한당뇨병학회. 2008 ; 32(4) : 366-376.
  20. 김기훈, 박재용, 한창현. 종합전문요양기관에 입원한 뇌졸중환자의 진료비 분석. 병원경영학회지. 2009 ; 14(4) : 71-87.
  21. 서미경, 이석구. 한방병원 입원환자의 진료비 구조 분석. 보건행정학회지. 1996 ; 6(2) : 115-130.
  22. 강탁림. 한방병원 입원환자의 진료과별 및 재원일별 평균진료비의 분포적 특성. 대한예방한의학회지. 2000 ; 4(1) : 91-103.
  23. 구미자. 양․한방 협진 병원의 뇌졸중 환자에 대한 비용 분석. 숙명여자대학교 임상약학대학원 석사학위논문. 2009.
  24. 통계청. 한국표준질병․사인분류(KCD-5). 2007.
  25. 유왕근. 한방의료서비스에 대한 인식도 및 개선요구도. 대한예방한의학회지. 2003 ; 7(2) : 45-64.
  26. 박현애, 황지인. 한국 성인의 의료이용 양상과 결정요인. 의료경영학연구. 2007 ; 1(1) : 59-67.
  27. 강수진, 이영준. 대구지역의 한방 의료서비스 이용 실태. 대한예방한의학회지. 2010 ; 14(2) : 67-75.
  28. 이규식, 조경숙. 한방의료 이용실태에 관한 조사 연구 : 전국 한의원 이용자를 중심으로. 보건행정학회지. 1999 ; 9(4) : 120-139.
  29. 김성진, 남철현, 김재돈, 김병화, 김기열. 한방의료이용 행태와 이에 영향을 미치는 요인 분석. 대한예방한의학회지. 2004 ; 8(1) : 89-107.
  30. 국민건강보험, 건강보험심사평가원. 2009 건강보험 통계연보. 2010.
  31. Dewey HM, Thrift AG, Mihalopoulos C, Carter RR, Am Mcneil JJ, Donnan GA. Lifetime cost of stroke subtypes in Australia : Findings from the North East Melcourne Stroke Incidence Study(NEMESIS). Stroke. 2003 ; 34 : 2502-2507. https://doi.org/10.1161/01.STR.0000091395.85357.09
  32. Chang KC, Tseng MC. Costs of acute care of first-ever ischemic stroke in Taiwan, Stroke. 2003 ; 34 : e219-221. https://doi.org/10.1161/01.STR.0000095565.12945.18
  33. 이경진, 이원일, 김용미, 성선숙, 추현숙, 이애심. 재원일수 단축을 통한 병원 수익증대. 한국의료QA학회 가을학술대회. 2005(2) : 361-362.
  34. 고민석. 공공병원의 생산성에 관한 연구. 원광대학교 대학원 박사학위논문. 2008.
  35. 김종인, 고민석. 공공병원의 부가가치생산성에 미치는 요인. 보건과 복지. 2008 ; 10 : 9-25.
  36. 김영훈, 문재우, 김기훈. 재원일별 진료비 발생양상과 재원일수의 결정요인. 병원경영학회지. 2010 ; 15(2) : 15-26.