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KMID : 1235020120060040001
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Health Service Management Review
2012 Volume.6 No. 4 p.1 ~ p.10
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A Study on Characteristic of Optimal Medical Institution Classification for Conversion Factor Contract
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Yoon Sung-Man
Jung Hyung-Rok
Kim Mi-Ok
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Abstract
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Health insurance fees are set by relative value scales and conversion factor. Since 2008, conversion factors have been contracted separately with 7types of providers as the characteristics of providers are different. Therefore, it became one of the most important issues to find optimal medical institution classification in conversion factor contract. In this study, we investigate specific factors which affect the medical institution classification for conversion factor contract types. Using data from National Health Insurance Corporation, we analyzed the difference among several factors. When we classify the medical institution by service, size, location, and ownership, the result shows that there are statistically significant differences among these factors. It implies that the revenue and cost structure of medical institution are affected by these factors. This paper contributes to health insurance authorities in that they should consider these factors when they classify medical institution for conversion factor contract.
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KEYWORD
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Conversion Factor, Medical Institution Classification, National Health Insurance
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