Korean J Prev Med.  1981 Oct;14(1):3-12.

Changes in Hospital and Clinic Care Patterns Under the Medical Insurance System

• Suh I

Abstract

To identify the changes in profession care patterns after the introduction of medical insurance in korea, professional care in hospitals and clinics of two succeeding years were compared. The hospital and clinics selected for this study were those which located in Seoul city. Hospital were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtain form the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studies were 3 months of each year form March 1st to May 3st in 1979 and 1980. The total number of normal deliverly studied was 289 in 1979, 301 in 1980 respectively and acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both disease in all types of hospital, but in the private clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities. More cost changes by items were seen in acute appendicitis than in normal deliverly between two study periods. The total hospital costs can be divided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospital was mainly due to the increase in the costs for drug for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal deliverly was characteristically increased in 1980 in all hospitals studied. In general in the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mention changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.L.C. for the assessment of the fee request made by clinics and hospitals.

MeSH Terms

Administration, Oral
Appendicitis
Fees and Charges
Hospital Costs
Hospitals, General
Hospitals, University
Insurance*
Korea
Length of Stay
Seoul