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개호보험의 실시가 병원경영에 미치는 영향 : 일본 후라데 니시노병원의 경영사례를 중심으로
南銀祐,徐種範,西野憲一,芭修一 고신대학교 보건과학연구소 2002 보건과학연구소보 Vol.12 No.-
Since the introduction of Long Term Care Insurance (Kaigohoken), the hospital management style in Japan has changed. The experiences of the Japanese can be used by the Koreans to improve their hospital management style. The Case study hospital, The Nishino General hospital, had established an intermediate facility (Rojinhokenshisetsu) which consisted of a home care service center, a visiting nursing center etc. to form a health, medical and welfare mix style management system. For the analysis of the system, how it was established and management, we studied the financial statements of the 2001 Furate (Corporation of Nishino hospital etc.). From the analysis of the financial statements one could see that the Rojinhokenshisetsu had a higher profit margin than the hospital itself. This has to do with the Japanese government's administrative plan in decreasing the number of acute hospitals while trying to increase the number and upbringing of long term care facilities and mixed style welfare service facilities. And the reason for the difference in profit is because of the quick response of the hospitals in following the plan. This conversion of administrative plans and medical management structure has not only decreased the national medical expense but has also given the regional population a comprehensive health care system and can be seen as a desirable model. Owing to the desirable changes from the conversion in administrative plans and medical management structure brought on by the Long Term Care Insurance in Japan, one can see Korea also applying such methods and forming a Long Term Care Insurance in the near future.
남은우,박경화,허종,서종범,임부경,西野憲史,芭修一 고신대학교보건과학연구소 2001 보건과학연구소보 Vol.11 No.-
Since increasing number of the elderly, Korean society has discussed needs of long-term care insurance for them. Those Japanese experiences should give lots of implications to manage institutions for caring dementia patients in Korea. In the case of Japan, if hospitals hospitalized dementia elderly patients with strange behaviors (like wandering) over one third of all patients, the hospitals can take higher nursing care fee due to needs of special protective cares. Japanese long-term insurances allow dementia patients to the reconstructive fee of elder dementia wards in short-term intensive cares. This policy encompassed day care fee, hospitalization fee of a serious dementia patient and hospitalization fee for the elderly dementia patients. Long term care coverage of Japan (Kanbyoungin-ryo) reimburses long-term care assistance (a Japanese care manager, or Kaigo hoken staffs) but health insurance coverage of Korea do not have that coverage. As a result, all patients have paid that cost since Korean medical care law did not permit long term care hospitals and did not allow special reimbursement of staffs who work for long-term care. Thus, Korean medical care law should be revised and allow nursing fee (kanbyoungin-ryo) to health care organizations.