3 research outputs found
μ ν¬κ΄μκ°μ λκ° μλ£κΈ°κ΄μ ν¨μ¨μ±μ λ―ΈμΉ μν₯
νμλ
Όλ¬Έ (μμ¬)-- μμΈλνκ΅ νμ λνμ 곡기μ
μ μ±
νκ³Ό, 2017. 8. λ°μ ν.λ§μ κ΅κ°λ€μ΄ μλ£λΉ κΈμ¦μ λν λ¬Έμ λ₯Ό ν΄κ²°νκΈ° μν΄ μ§λ£λΉμ§λΆμ λ κ°νμ μλνκ³ μλ€. μ§λ£λΉμ§λΆμ λμ κ°νμ μλ£λΉλ₯Ό ν΅μ νκ³ μ νλ λͺ©μ μμ μ λΆμνμ (Prospective Payment System) λμ
μ μ€μ¬μΌλ‘ μ΄λ£¨μ΄μ§κ³ μλ€. μ°λ¦¬λλΌλ μ΄μ κ°μ λ§₯λ½μμ μ λΆμνμ λ‘μ μ νμ λͺ¨μνκ³ μμΌλ©°, κ·Έ κ³Όμ μμ κΈ°μ‘΄μ νμλ³μκ°μ μ 7κ° μ§λ³κ΅°λ³ ν¬κ΄μκ°μ μ νκ³λ₯Ό 극볡ν λͺ¨νμΈ μ ν¬κ΄μκ°μ λλ₯Ό κ°λ°νμ¬ νμ¬ μλ²μ¬μ
μ€μ μλ€. μ λΆμνμ λ μ΄λ‘ μ μΌλ‘ μλ£κ³΅κΈμμκ² μλ£μλΉμ€μ ν¨μ¨μ±μ ν₯μ μν€κ³ μ νλ μΈμΌν°λΈλ₯Ό μ£Όλ©°, μΌλ°μ μΌλ‘ μ λΆμνμ μ λμ
μ μλ£κΈ°κ΄μ ν¨μ¨μ±μ ν₯μμν¨λ€κ³ μλ €μ Έ μλ€. λ³Έ μ°κ΅¬λ μ΄λ¬ν μ΄λ‘ μ κ·Όκ±°κ° μ ν¬κ΄μκ°μ λμλ μ μ©λλμ§ μ€μ¦νκ³ μ νμλ€. μ°κ΅¬ λμμ μ ν¬κ΄μκ°μ λκ° λμ
λ 28κ°μ μ’
ν©λ³μκΈ μλ£κΈ°κ΄μ΄λ©°, λΉκ΅μ§λ¨μΌλ‘λ μ ν¬κ΄μκ°μ λκ° λμ
λμ§ μμ 199κ° μ’
ν©λ³μκΈ μλ£κΈ°κ΄μ μ μ νμλ€. μ°κ΅¬κΈ°κ°μ 본격μ μΌλ‘ μ ν¬κ΄μκ°μ λκ° λμ
λκΈ° μμν 2012λ
μ κΈ°μ€μΌλ‘ λμ
μ (2010λ
ο½2011λ
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ν(2013λ
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μ΄λ€. μ°κ΅¬λ 2λ¨κ³λ‘ λλμ΄ μννμλ€. λ¨Όμ 1λ¨κ³μμλ μλ£ν¬λ½λΆμ(DEA)μ μ΄μ©νμ¬ μ°κ΅¬λμ μλ£κΈ°κ΄μ ν¨μ¨μ±μ μΈ‘μ νμλ€. 2λ¨κ³μμλ μ ν¬κ΄μκ°μ λμ μμν λμ
ν¨κ³Όλ₯Ό λΆμνκΈ° μν΄ 1λ¨κ³μμ λμΆν ν¨μ¨μ± μ μλ₯Ό μ΄μ©ν μ΄μ€μ°¨μ΄λΆμ(DID)μ μ€μνμλ€. μ°κ΅¬κ²°κ³Ό 1λ¨κ³μμ μ ν¬κ΄μκ°μ λλ₯Ό λμ
ν μλ£κΈ°κ΄μ ν¨μ¨μ±μ μΈ‘μ ν κ²°κ³Ό μ λ λμ
μ β€νμμ ν¨μ¨μ±μ ν₯μμ κ΄μ°°νμλ€. νμ§λ§ 2λ¨κ³ μ΄μ€μ°¨μ΄λΆμκ²°κ³Ό μ΄λ¬ν λ³νκ° μ ν¬κ΄μκ°μ λ λμ
μΌλ‘ μΈν μμν ν¨κ³ΌμΈμ§μ λν΄μλ ν΅κ³μ μΌλ‘ λ°νμ§ λͺ»νμλ€. μ΄λ€ μ μ±
μ ν¨κ³Όλ₯Ό νκ°νκΈ° μν΄μλ μ μ±
μ΄ μ μ©λ μμ€ν
μ΄λ μ§λ¨μ λ³νλ₯Ό μΈ‘μ ν μ μμ΄μΌ ν κ²μ΄λ€. μ ν¬κ΄μκ°μ λμ λμ
λͺ©μ κ³Ό μ·¨μ§μ λΉμΆμ΄ 보μμ λ μ λκ° λμ
λ μλ£κΈ°κ΄μ ν¨μ¨μ± μΈ‘μ μ νμμ μ΄λΌ ν μ μλ€. νμ€μ μΌλ‘ μλ£κΈ°κ΄μ ν¨μ¨μ±μ μΈ‘μ νλ κ²μ΄ μ©μ΄νμ§ μμ μΈ‘λ©΄μ΄ μμ§λ§, μ ν¬κ΄μκ°μ λμ μμ μ μΈ μ΄μκ³Ό νλλ₯Ό μν΄μλ λ€μν λ°©λ²μ ν΅ν μλ£κΈ°κ΄ ν¨μ¨μ± μΈ‘μ μ΄ λ°λ³΅μ μΌλ‘ μ΄λ£¨μ΄μ ΈμΌ ν κ²μ΄λ€. λ³Έ μ°κ΅¬μ λ°©λ²κ³Ό κ²°κ³Όκ° μ ν¬κ΄μκ°μ λμ λμ
ν¨κ³Όλ₯Ό μλ£κΈ°κ΄μ ν¨μ¨μ± μΈ‘λ©΄μμ νκ°νκ³ μ νλ νμ μ°κ΅¬λ€μκ² μ‘°κΈμ΄λλ§ κΈ°μ¬ν μ μκΈ°λ₯Ό ν¬λ§νλ€.μ 1 μ₯ μλ‘ 1
μ 1 μ μ°κ΅¬μ λ°°κ²½ λ° νμμ± 1
μ 2 μ μ°κ΅¬μ λͺ©μ 4
μ 2 μ₯ μ΄λ‘ μ λ
Όμ λ° μ νμ°κ΅¬ κ³ μ°° 5
μ 1 μ μ§λΆμ λμ μλ£κΈ°κ΄ ν¨μ¨μ±μ λν λ
Όμ 5
1. μ§λ£λΉμ§λΆμ λμ κ°λ
5
2. μ°λ¦¬λλΌμ μ§λΆμ λμ λν κ³ μ°° 7
3. μ ν¬κ΄μκ°μ λμ
κ³Ό μλ£κΈ°κ΄ ν¨μ¨μ±μ λν λ
Όμ 10
μ 2 μ μ νμ°κ΅¬ κ³ μ°° 11
μ 3 μ₯ μ°κ΅¬λ°©λ²λ‘ 16
μ 1 μ μλ£κΈ°κ΄μ ν¨μ¨μ± μΈ‘μ : μλ£ν¬λ½λΆμ(DEA) 16
1. ν¨μ¨μ±μ κ°λ
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2. μλ£κΈ°κ΄μ μ°μ
μ νΉμ§κ³Ό ν¨μ¨μ± 18
3. μλ£κΈ°κ΄μ ν¨μ¨μ± μΈ‘μ λ°©λ² 19
4. μλ£ν¬λ½λΆμ(Data Envelopment Analysis) 20
μ 2 μ μ ν¬κ΄μκ°μ λμ λμ
ν¨κ³Ό μΈ‘μ : DID 25
1. μ΄μ€μ°¨μ΄λΆμ(DID)μ κ°λ
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2. μ΄μ€μ°¨μ΄λΆμ λͺ¨νμ μ€κ³ λ° ν΄μ 26
μ 4 μ₯ μ°κ΅¬λͺ¨ν λ° λ°©λ² 29
μ 1 μ μ°κ΅¬λͺ¨ν 29
1. μ°κ΅¬λ΄μ© 29
2. λΆμλͺ¨ν 31
μ 2 μ μ°κ΅¬λ°©λ² 35
1. μ°κ΅¬λμ 35
2. DEA λͺ¨νμ μν λ³μμ μ 37
3. μ΄μ€μ°¨μ΄λΆμ λͺ¨νμ μν λ³μμ μ 43
μ 5 μ₯ μ°κ΅¬κ²°κ³Ό 45
μ 1 μ μ°κ΅¬ λμμ μΌλ°μ μΈ νΉμ± 45
μ 2 μ DEA λΆμ κ²°κ³Ό 50
μ 3 μ μ ν¬κ΄μκ°μ λκ° μλ£κΈ°κ΄μ ν¨μ¨μ±μ λ―ΈμΉλ μν₯ 53
1. λ¨μμ΄μ€μ°¨μ΄ λΆμκ²°κ³Ό 53
2. μ΄μ€μ°¨μ΄ νκ·λͺ¨ν λΆμκ²°κ³Ό 54
μ 6 μ₯ κ³ μ°° 56
μ 1 μ μ°κ΅¬λ°©λ²μ λν κ³ μ°° 56
1. μλ£ν¬λ½λΆμ(DEA)μ μ μ© λ° νκ³ 56
2. μ΄μ€μ°¨μ΄λΆμ(DID)μ μ μ© λ° νκ³ 58
μ 2 μ μ°κ΅¬ κ²°κ³Όμ λν κ³ μ°° 60
μ 3 μ μ°κ΅¬μ μμ¬μ 62
μ°Έκ³ λ¬Έν 64
Abstract 74Maste
Effects of New Diagnosis-Related Group-Based Payment on Efficiency of Public Hospitals
λ§μ κ΅κ°λ€μ΄ μλ£λΉ κΈμ¦μ λν λ¬Έμ λ₯Ό ν΄κ²°νκΈ° μν΄ μ§λ£λΉμ§λΆμ λ κ°νμ μλνκ³ μλ€. μ§λ£λΉμ§λΆμ λμ κ°νμ μλ£λΉλ₯Ό ν΅μ νκ³ μ νλ λͺ©μ μμ μ£Όλ‘ μ λΆμνμ λμ
μ μ€μ¬μΌλ‘ μ΄λ£¨μ΄μ§κ³ μλ€. μΌλ°μ μΌλ‘ μ λΆμνμ λ₯Ό λμ
ν κ²½μ° μλ£κΈ°κ΄μ ν¨μ¨μ±μ΄ ν₯μλλ€κ³ μλ €μ Έ μλ€. λ³Έ μ°κ΅¬λ μ΄λ¬ν μ΄λ‘ μ κ·Όκ±°κ° μ ν¬κ΄μκ°μ λμλ μ μ©λλμ§ μ€μ¦ λΆμνλ€. μ°λ¦¬λλΌλ νμ¬ μ ν¬κ΄μκ°μ λ₯Ό 곡곡μλ£κΈ°κ΄μ νμ νμ¬ μλ² μ΄μ μ€μ μλ€. λ³Έ μ°κ΅¬λ μ ν¬κ΄μκ°μ λ λμ
μ (2010λ
~2011λ
)κ³Ό λμ
ν(2013λ
~2016λ
)λ₯Ό μ νλ‘ μ€νμ§λ¨μΈ μ’
ν©λ³μκΈ 28κ° κ³΅κ³΅μλ£κΈ°κ΄κ³Ό μ ν¬κ΄μκ°μ κ° μ μ©λμ§ μλ λΉκ΅μ§λ¨μΈ λ―Όκ°μλ£κΈ°κ΄ 199κ°λ₯Ό λμμΌλ‘ μ ν¬κ΄μκ°μ λμ λμ
μ΄ μλ£κΈ°κ΄μ ν¨μ¨μ±μ μν₯μ λ―ΈμΉλμ§ λΆμνμλ€. μλ£ν¬λ½λΆμ(DEA)κ³Ό μ΄μ€μ°¨μ΄λΆμ(DID)μ μ΄μ©νμ¬ λΆμν κ²°κ³Ό μ ν¬κ΄μκ°μ λ λμ
μ νλ‘ μλ£κΈ°κ΄ ν¨μ¨μ±μ μ μλ―Έν ν₯μμ κ΄μ°°νμμ§λ§, μ΄λ¬ν λ³νκ° μ ν¬κ΄μκ°μ λλ‘ μΈν λ³νμΈμ§λ ν΅κ³μ μΌλ‘ λ°νμ§ λͺ»νμλ€. μ΄λ μ ν¬κ΄μκ°μ λκ° μλ² μ¬μ
μ€μΈ 곡곡μλ£κΈ°κ΄μ κ³΅κ³΅μ± νΉμ±μΌλ‘ 곡κΈμ μΈμΌν°λΈμ λν΄ λ λ―Όκ°νκ² λ°μνμ κ°λ₯μ±μ΄ μμΌλ©°, λ°λΌμ ν¨μ¨μ±μ λ―ΈμΉλ μν₯μ΄ κ³Όμ μΆμ λμμ κ°λ₯μ±μ΄ μλ€.Many countries in the world including Korea are trying to reform their medical insurance payment systems to solve the problem of surging medical expenses. Reform of the payment system is mainly focused on the introduction of the Prospective Payment System in order to control surging medical expenses. In general, the Prospective Payment System is recognized as a very effective measure to enhance the efficiency of medical institutions. This study attempts to analyze whether this rationale applies to the new Diagnosis-Related Group-Based payment system in Korea. Korea is currently piloting a new Diagnosis-Related Group-Based payment system to public medical institutions. Whether introduction of the new Diagnosis-Related Group-Based payment system had an effect on the efficiency of medical institutions during the period prior to introduction (2010~2011) and after introduction (2013~2016) was assessed by selecting 28 public general hospitals as the experimental group and 199 private hospitals that had not adopted Diagnosis-Related Group-Based payment system yet as the control group. The results used Data Envelopment Analysis (DEA) and Difference-in-Difference Analysis (DID) and showed that the overall improvement of the efficiency score of medical institutions is observed before and after the introduction of the new Diagnosis-Related Group-Based payment system. However, no statistical evidence was able to be provided as to whether such efficiency improvement is attributable to the new Diagnosis-Related Group-Based payment system