Health Policy Manag.  2019 Mar;29(1):40-48. 10.4332/KJHPA.2019.29.1.40.

Changes in the Medical Cost and Practice Pattern according to the Implementation of per Diem Payment in Hospice Palliative Care

• Lim MN
• Choi SW
• Ryu SY
• Han MA

• KMID: 2446851
• DOI: http://doi.org/10.4332/KJHPA.2019.29.1.40

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.

Keyword

Hospices; Per diem payment; Fee-for-service plans; Medical service charge; Medical practices

MeSH Terms

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