Methods and Applications to estimate the Conversion Factor of Resource-based Relative Value Scale for Nurse-Midwife's Delivery Service in the National Health Insurance
Journal of Korean Academy of Nursing
;
: 574-583, 2009.
Artículo
en Coreano
| WPRIM
| ID: wpr-174033
ABSTRACT
PURPOSE:
This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services.METHODS:
A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis.RESULTS:
The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services.CONCLUSION:
Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Escalas de Valor Relativo
/
Costos y Análisis de Costo
/
Reembolso de Seguro de Salud
/
Corea (Geográfico)
/
Programas Nacionales de Salud
/
Enfermeras Obstetrices
Tipo de estudio:
Evaluación Económica en Salud
/
Estudio pronóstico
Límite:
Femenino
/
Humanos
/
Embarazo
País/Región como asunto:
Asia
Idioma:
Coreano
Revista:
Journal of Korean Academy of Nursing
Año:
2009
Tipo del documento:
Artículo
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