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서울시내 병원의 경장영양식 보험수가에 대한 영양사의 견해 분석
김혜진 ( Hye Jin Kim ),목희정 ( Hee Jung Mok ),홍정임 ( Jeong Im Hong ),허규진 ( Gyn Jin Heo ),이인규 ( In Kyu Lee ) 한국정맥경장영양학회 2013 한국정맥경장영양학회지 Vol.5 No.3
Purpose: Enteral nutrition is an efficient method of providing nutrition, which has significant clinical advantages. However, it presents difficulties of ensuring an adequate supply and management because meal wages are insurance- inclusive. By understanding the management status of enteral nutrition in hospitals in Seoul and seeking the opinions of experienced nutritionists on governmentpaid meal wages, we acquired basic data for review of patient meal wages and the insurance system. Methods: Investigation of medical institutions in Seoul was performed through a survey conducted from October 15 to October 31 2012. Twenty-eight questionnaires on the current situation and 103 questionnaires on individual opinions were analyzed. Descriptive analysis, chi-square test, and ANOVA were performed using PASW Statistics 18.0. Results: Regarding satisfaction with enteral nutrition, 93.0% reported that the major complication was diarrhea. Among the list of difficulties in case of complications, lack of diversity was 56.1%. The No. 1 influence in selection of enteral nutrition was ‘Cannot use expensive products because of insufficient medical fees,’ at 45.0%, while No. 2 was ‘Cannot use a variety of products because of insufficient medical fees’ at 26.3%. No. 1 in needs for improvement of enteral nutrition was ‘modifications and complements to insurance fee,’ at 43.0%, No. 2 was ‘pricing by volume`` at 26.0%. More than 98% of respondents answered that systematic development of insurance fees for enteral nutrition according to type of hospital and management was needed. Conclusion: Development of various products and multiple team activities through the Nutrition Support Team are needed for the efficient supply of enteral nutrition. In addition, the revision of cost reimbursement for health insurance by understanding the current status, suggesting an appropriate level of enteral nutrition supply at a government level and providing systematic procedures, including continuous evaluation tools and management, are urgently needed. (J Korean Soc Parenter Enter Nutr 2013;5(3):122-129)
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