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KMID : 0603920060140030085
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Journal of Korean Academy of Occupational Therapy
2006 Volume.14 No. 3 p.85 ~ p.92
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The Application of the New Health Insurance Fee Establishment on the Occupational Therapy Service: A Case Study
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Lee Ji-Hyun
Yum Dong-Sam
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Abstract
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Objective : This study is to find out how the new establishment of health insurance fee and its application influence on revenue of occupational therapy service.
Methods : We have investigated the health insurance fee and the evaluation items which are currently applied in the occupational therapy service of a university hospital. And we have classified the items which are running but not compensated appropriately in the care unit, so then established them as health insurance exclusion clauses and fixed health insurance fee. We have also investigated the influence on revenue of occupational therapy service with utilizing items which are not used.
Results : We set up the below items as health insurance exclusion clauses; cognitive faculty test and organization ability test, finger-tapping test and Denver developmental test. In case of rehabilitative dysphagia therapy, as though it belongs to health insurance fee, the patients was not supposed to pay for the therapy commonly. So then we set the patients to pay for rehabilitative dysphagia therapy. The profit rate was increased 88% per month by new health insurance fee, on the average.
Conclusion : This study has shown that the active use of health insurance fee appears to be effective on increasing its revenue, and so development of health insurance pay item will compensate for occupational therapy service and its revenue effect will offer an option to promote the establishment and operation of occupational therapy service. And it will serve as a momentum to broaden the position of occupational therapy.
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KEYWORD
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Health insurance, Health insurance exclusion clauses, Revenue
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