의료보험 다빈도 입원상병의 진료비 및 재원일수 분석 = An Analysis of Changes and Length of Stay of Frequently Claimed Inpatiten Diseases

다국어 초록 (Multilingual Abstract)

An effective management of frequently occurring inpatient diseases becomes increasingly important in the situation under which the range of medical insurance benefits are expanded. This study attempts to analize the distribution and occurance rate of the insurance claims, the relative level and variance of ,the inpatient charges and length of stay and the degree of effects the patient and hospital related variables have on the charges and duration of stay. Five frequently claimed inpatient diseases were selected ; delivery in a completely normal case, acute appendictis, chronic liver disease and cirrhosis, diabetes, and malignant neoplasm of stomach. Relevant data were collected for the year 1991 from the computer database of the Korea Medical Insurance Corportion and analysed using relevant computer-aided statistics programs. Major findings and conclusions are as follows ;
Firstly, the coefficient of variance of the charges and length of stay were found to be high when they are more chronic and when the inpatients are admitted in the teriary hospitals. For the effective control of the medical insurance expenditure it is suggested that the variance be reduced and that diseases and hospitals which have high variance be managed.
Secondly, the variance of per case charges of the disease were explained as much as 39.5% to 64.3% by the variable "day of stay" and 7.4% to 31.4% by the variable "average daily charge", which means that they can be used as decisive factors to control the medical insurance expenses.
Thirdly, the patient and hospital related variables which are non-clinical and non-diagnostic/therapeutic were found to have the R2 value less than 0.1, which means that they are not important factors affecting the days of stay and avererage daily charges. However, it was found that such variables as hospital's type, teaching status and hospital location and patient's age have relatively high explanatory power ranging 3.1% to 8.3% respectively. This implies that the variables can be utilized as a policy tool for the effective control of the medical expenses.

목차 (Table of Contents)

• Ⅰ. 서론
• Ⅱ. 연구방법
• Ⅲ. 분석 및 고찰결과
• Ⅳ. 요약 및 결론