To Ientify the changes in professional services pattern after inl roduc:Mg the del-gated system of claims review started in 1982, a university hospital under t"ns system o v,,as examined.
For comparison, claims of the hospital to Federation of Korean Aledical insurance Societies, where this system is not accepted, were reviewed. A total of 634 cases each were studied operated at the Departments of General Surgery & Orthopedic Surgery in and 1983.
The results are summarized as follow:
1. Percentages of hospital charges for basic care was decreased by 19.2% and that for medical service increased by 8.410o in 1983.
2. After the introduction of the deligated review system, percentages of cutting off ti.e claims was decreased by 12.4% for basic care and increased by 3.8~; for zredical services.
3. Percentage of testing liver function, and the frequency of ad niniste,ing high ccst intravenous fluid injection, applicating Robinul as anesthietic premed:cation were decreased respectively after introducting the deligated services system.
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