외부병원 필름판독료 수가 개선에 따른 효과평가 연구

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Brain MRIexternal image decipher feepolicy effectcoverage expansionmedical service use routehealthcare resourcefee schedule revision
As part of coverage expansion plan, the government decided to include brain-related MRI scan into the benefit package, and raised external MRI image decipher service fee for healthcare service providers in an attempt to induce appropriate level of service use. As MRI scan of spine and musculoskeletal system are planned to gradually come into national health insurance package, there is a need for a continued improvement of MRI coverage policy. To enable such improvement, this study aims to provide effectiveness assessment and suggestions for proper management measures.
This study analyzed policy effectiveness of health service usage pathway before and after MRI inclusion into the benefit package of national health insurance system. Regarding analysis method, 30-day healthcare service use data of patents who received brain-related MRI scan were structured by episode and analyzed with t-test and Logit, in order to see the difference between before and after the policy implementation.
The result showed that the increased decipher authority of specialist physicians led to more MRI image decipher cases of external clinics. As a result of increased MRI image decipher fee, there was an uplift of external MRI decipher cases, when compared to before the policy change. It means that more
providers chose to use MRI scan taken by other clinic or hospital, rather than performing another scan at their own facility.
The type of providers performing MRI scan was divided into two groups: general/tertiary hospitals, and hospitals and clinics. Policy effect was analyzed by patients' route, and it was shown that different routes had different policy effect. Based on the result, raise of MRI decipher fee was proposed for rational use pattern of healthcare resource, such as getting MRI scan with 3 Tesla MRI at a general or tertiary hospital, and visiting a hospital or clinic to get it deciphered.
In order to build and operate an efficient and comprehensive healthcare resource management system, exchange of medical image data should be available more easily and conveniently. Such improvement is expected to contribute to reduction of reduced social cost and stabilization of the National Health Insurance fund.
Alternative Title
Effectiveness assessment study upon fee revision of external MRI image decipher price
Table Of Contents
요 약 ------------------------------- ⅰ

제1장 서 론 ------------------------------- 1
1. 연구 배경 ------------------------------- 1
2. 연구 목적 ------------------------------- 2
3. 연구 내용 및 방법 ------------------------------- 2

제2장 문헌고찰 및 동향검토 ------------------------------- 3
1. 국내 문헌 고찰 ------------------------------- 3
2. 미국의 MRI영상 관리 현황 ------------------------------- 7
3. 대만의 MRI영상 관리 현황 ------------------------------- 11

제3장 뇌 관련 MRI 현황 분석 ------------------------------- 15

제4장 뇌 관련 MRI 데이터 분석 방향 설정 ------------------------------- 29
1. 분석 데이터 구축 ------------------------------- 29
가. 데이터 추출 ------------------------------- 29
나. 분석기준 설정 ------------------------------- 30
2. 뇌 관련 MRI 정책효과 분석 방법 ------------------------------- 31
가. MRI 촬영 후 타 기관 재촬영 및 외부 MRI 판독료 지표 산출 ------------------------------- 31
나. 뇌 관련 MRI 지표를 활용한 정책효과 분석 ------------------------------- 31

제5장 뇌 관련 MRI 정책효과 분석 ------------------------------- 33
1. 뇌 관련 MRI 촬영 후 이용현황 분석 ------------------------------- 33
2. 뇌 관련 외부 MRI 판독료 발생 후 이용 분석 ------------------------------- 47

제6장 정책효과 실증분석 ------------------------------- 59
1. 분석 방법 ------------------------------- 59
2. 변수 설명 ------------------------------- 59
가. 종속변수 ------------------------------- 59
나. 설명변수 ------------------------------- 60
다. 변수 항목 ------------------------------- 60
3. 모형 분석 ------------------------------- 61
가. 분석 결과 ------------------------------- 61
나. 분석 결과 해석 ------------------------------- 62

제7장 제언 및 결론 ------------------------------- 63

ABSTRACT ------------------------------- 66

부 록 ------------------------------- 68
김록영 et al. (202011). 외부병원 필름판독료 수가 개선에 따른 효과평가 연구.
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