HIRA

소아응급의료 확충을 위한 수가 개선방안 연구

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Type
Research report
Author(s)
류정민최승준정진희김미진이현정노현이진희김도균윤서희임택진서정호
Issued Date
2023-08
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3223
Table Of Contents
제1장 연구개요 및 방법 ······································ 1
1. 연구 배경 및 필요성 ······································· 3
가. 연구 배경 ················································ 3
나. 연구의 필요성 ············································· 6
2. 연구 목적 ·············································· 6
3. 연구내용 및 방법 ········································· 6
가. 국내ž외 소아응급의료체계 현황과 고찰 ···························· 6
나. 소아응급진료 현황 분석 ······································ 7
다. 소아응급의료 수가개선 및 소아응급의료 확충방안 ···················· 7

제2장 국내·외 소아응급의료체계 ······································ 9
1. 국내 소아응급의료체계 ·································· 11
가. 국내 소아응급의료체계 발전배경 ···························· 11
나. 소아전문응급의료센터 도입과 지정 현황 ······················ 11
다. 소아 야간, 공휴일 진료체계 ································ 13
라. 소아응급 세부전문의 제도 도입 ····························· 14
2. 미국의 소아응급의료체계 ································ 14
가. 소아응급의료체계 특징과 재정 ······························ 14
나. 미국 소아응급의료 체계 구성 요소 ·························· 16
다. 미국 소아응급의료체계 시사점 ······························ 21
3. 일본의 소아응급의료체계 ································ 22
가. 일본의 소아응급의료체계 특징 ······························ 22
나. 일본의 소아응급의료체계 단계 ······························ 22
다. 소아응급의료체계 단계별 구체적 역할 ························ 23
라. 일본의 소아진료비 보험 수가 및 가산제도 ···················· 27
마. 일본 소아응급의료체계의 시사점 ···························· 30

제3장 소아응급진료 현황 ······································ 31
1. 소아전문응급의료센터 청구 현황 ·························· 33
가. 분석방법 ··············································· 33
나. 소아전문응급의료센터 청구건수 분석 ························· 37
다. 소아 중증응급상병군(가칭) 정의와 청구건수 분석 ··············· 54
라. 소아전문응급의료센터 요양급여비용 분석 ····················· 64
마. 소아전문응급의료센터 필수행위 ····························· 73
바. 코로나 전후 2년간 진료현황 및 청구현황 비교 ················· 77
2. 전국 응급실 소아진료 현황 ······························· 84
가. 분석대상과 자료 ········································· 84
나. 분석결과 ··············································· 86

제4장 소아응급의료 확충을 위한 개선방안 ······································ 123
1. 소아응급실 의료진 포커스그룹 면담 ······················· 125
가. 포커스그룹 면담 목적 ···································· 125
나. 포커스그룹 면담 대상과 방법 ······························ 125
다. 포커스그룹 면담 내용 ···································· 126
라. 포커스그룹 면담 결과 ···································· 127
마. 개별 행위에 대한 수가 개선 의견 ·························· 137
2. 사후보상지불제도와 지방자치단체 소아응급 지원사례 ········· 141
가. 사후보상 지불제도 방식 검토 ······························ 141
나. 국내 지방자치단체 소아응급진료 지원 사례 검토 ·············· 152
3. 소아응급의료체계 개선을 위한 전문가 조사 ················· 154
가. 전문가 조사 목적과 방법 ································· 154
나. 전문가 조사 결과 ······································· 156

제5장 연구 결론 및 제언 ······································ 165
1. 연구 결론 ··········································· 167
가. 우리나라 소아응급의료 현황 ······························· 167
나. 소아응급의료체계와 수가 개선방안 ························· 169
2. 소아응급의료체계 구축을 위한 제언 ······················· 172
가. 소아응급의료체계 개선을 위한 로드맵 ······················· 172
나. 한국형 소아응급의료체계 구축 방안 ························· 174
다. 소아응급진료 활성화 방안 ································ 185

◾ 부록 ············································ 189
Publisher
건강보험심사평가원
Location
KOR
Citation
류정민. (2023-08). 소아응급의료 확충을 위한 수가 개선방안 연구.
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