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자기공명영상 촬영수가 관련요인 분석

Other Titles
 (The) correlationship between the charge of MRI and associated factors 
Issue Date
2004
Description
병원행정학과/석사
Abstract
[한글] 이 연구는 MRI 촬영수가의 현황과 관련 요인을 분석하기 위하여 MRI 장비를 보유한 병원급 이상 의료기관을 대상으로 2003년 6월15일부터 11월15일까지 우편조사를 실시하여 회수된 83개 병원급이상 의료기관의 자료를 SPSS version 10.0을 이용하여 분석하였다. 분석방법은 기술통계량, ANOVA, t-검정, 분산분석, 상관분석, 다중회귀분석이 적용되었다. 연구의 주요결과는 다음과 같다. 1. 연구의 분석대상은 종합전문요양기관 31개소(37.3%), 종합병원 46개소(55.4%), 병원 6개소(7.2%)로 총 83개 기관이며, 소재지역별로는 서울 26개소(31.3%), 서울이외 지역 57개소(68.7%)였다. MRI 촬영장비는 병원당 평균 1.34대 였다. 2. MRI 장비 구입가격은 평균 17억 3천만원, MRI장비 1대당 촬영실 면적은 평균 110.5 m2, MRI 장비 1대당 년간 촬영건수는 평균 4,140회였다. 연구대상병원의 인력규모는 100병상당 진단방사선과 전문의수는 0.9명, 진단방사선과 기사수는 5.2명, 병원총직원수는 141.1명이었다. MRI 장비보유기관의 전문진료과목수는 평균 20.6 개 과목, 건강보험환자 진료비 점유율은 75.4%, 특수촬영점유율은 14.4% 이었다. 3. 병원규모별 MRI 촬영수가는 종합전문요양기관 50만 6천원, 종합병원 34만 4천원, 병원 31만 3천원이며, 전체 평균은 40만 3천원이였다. 병상규모가 800 병상이상인 경우는 51만 2천원이였다. 지역별로는 서울 46만 2천원, 서울이외 지역 37만 6천원이였다. 4. MRI 촬영수가 관련 요인은 의료기관 종별, 소재지역, MRI 장비 구입가격, 건강보험진료비 점유율이었다. 즉, 종합전문요양기관, 서울인 경우, 장비구입가격이 평균 이상인 경우, 건강보험환자 진료비 비중이 높은 기관에서 MRI 촬영수가가 유의하게 높았다. 결론적으로 MRI 촬영와 같은 비급여 의료수가 수준은 의료기관 유형, 소재지역, 장비구입 가격, 의료기관별 환자유형의 영향을 받는다고 볼 수 있다. 이 연구는 의원급 의료기관이 제외되었으며, 병원급 의료기관 83개소만 분석하였기 때문에 MRI 장비보유기관 전체를 대표하기 어렵고, 설문지를 통하여 자료를 수집하여 자료의 신뢰성을 검증하지 못하였다. 또한, MRI 촬영수가와 관련된 요인중 지역, 원가구성 특성을 세분화하지 못하여 수가결정 요인을 규명하지 못하였다. 따라서, 연구결과의 대표성을 확보하기 위하여 표본을 확대하고 수가 관련 요인의 특성을 구체화하는 연구가 필요하다. 다만, 이 연구는 MRI 촬영의 급여전환이 검토되는 시점에서 이루어진 조사연구이며, 고가장비를 이용한 의료서비스의 수가결정시 고려하여야 할 점을 시사하고 있다는 점에 그 의의가 있다.
[영문]The objective of this study is to analyze the correlationship between the charge of MRI and associated factors. The data was collected from 83 hospitals equipped with MRI throughout the mail survey from June 15 to November 15 in 2003. In addition, the SPSS Version 10.0 was used to analyze the collected data by applying descriptive statistics, ANOVA, t-test, correlation analysis, and multiple regression analysis. The significant study results are as follows. 1. The researched organizations include composite 31 tertiary hospital special medical organizations (37.3%), 46 general hospitals (55.4%), and 6 hospitals (7.2%)., which were located in Seoul (26; 31.3%) and in other than Seoul (57; 68.7%). The total number of their MRI filming equipments was 1.34 for each organization in average. 2. The average purchasing price for MRI equipments was 1,730,000,000 won, the space for each MRI equipment was 110.5 m2, and the average number of filming for each MRI equipment was 4,140 per year. The present status of labor per 100 beds in MRI organizations was 0.9 diagnostic radiologist, 5.2 radiology technicians, and 141.1 hospital employees. The number of departments of specialty was 20.6 in average and the ratios of health insurance patients’ medical fees and special filming were 75.4% and 14.4%, respectively. 3. The total average charge of MRI was 403,000 won: 506,000 won (tertiary hospital), 344,000 won (general hospitals), and 313,000 won (hospitals). Among these, the average charge of MRI at hospitals with more than 800 beds was 512,000 won. According to locations, the hospitals in Seoul and in other than Seoul charged 462,000 won and 376,000 won in average, respectively. 4. The factors correlated to MRI charge were types of hospitals, locations, MRI equipment purchasing prices, and ratio of health insurance medical cost. In other words, the charge for MRI was significantly high in tertiary hospitals, hospitals located in Seoul, hospitals with equipment purchasing prices higher than average, and hospitals with high ratio of health insurance patient’s medical fees. In conclusion, the non-reimbursable medical fee such as MRI filming can be influenced by hospital types, locations, equipment purchasing prices, and patient types. The limitations of this study are that the surveyed organizations do represent the whole MRI facilitated organizations; that the present status of clinics is excluded; and that it is hard to verify the reported data due to the data collection through data collection. Moreover, since the characteristics of locations and cost composition were not subdivided among MRI fee related factors, the medical fee determination factors were clarified. Therefore, in order to insure the representative ness of study results, it is necessary to expand the samples and specify the characteristics of medical fee related factors. However, this study presents its significance since it was conducted at the time that the reimbursement shifting of MRI filming was reviewed, and it suggests the points to consider in determining medical fee for services using high-price equipment.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/128861
Appears in Collections:
2. 학위논문 > 4. Graduate School of Public Health (보건대학원) > 석사
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