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KMID : 0364019920250040438
Korean Journal of Thoracic and Cardiovascular Surgery
1992 Volume.25 No. 4 p.438 ~ p.444
A Proposal for an Adjustment of Fee for Medical Insurance Sevice in the Field of Thoracic and Cardrovascular Surgery


Abstract
We analysed 7, 180 annual cases of surgical treatment performed by Department of Thoracic and Cardiovascular Surgery of 6 major institutes in Seoul Korea. All cases were applied to 101 of 140 coded items applicable to the field of Thoracic and
Cardiovascular Surgery, in the book of 'Standard Price List for Medical Service' which was notified by the Ministry of Health and Social Affairs, and of them, applied field specific items were 70 of 93 applicables. The most frequently applied
items
were
those associated to ECC(extra-corporeal circulation) 1,510 cases, and then item of closed thoracostomy 751 cases was next. Except the items associated to ECC, the coded item of the highest 'total cost(fee¡¿total applied numbers)' was mitral valve
replacement 182, 356, 570 won(534,770 won¡¿341 cases).
140 items were arranged in 'total cost' order, and then categorized into 5 groups. Medical insurance fees of each group were modified by different grades without changes in sum of total fees. Fees of group 1, the highest group in 'total cost',
were
pulled up, on the other hand, Group 4, the lowest group, were pulled down. Group 5, composed of overlapping items with other fields, were not changed.
The results of adjustment by grouping showed 21.2% increment effect(535,749,105 won) in real income. And we found that new coded items for modern high technological procedures should be added to 'Standard Price List for Medical Service'.
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