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.
Article
Dans Coréen
| 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.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Échelles de valeur relative
/
Coûts et analyse des coûts
/
Remboursement par l'assurance maladie
/
Corée
/
Programmes nationaux de santé
/
Infirmières sages-femmes
Type d'étude:
Évaluation en économique de la santé
/
Étude pronostique
Limites du sujet:
Femelle
/
Humains
/
Grossesse
Pays comme sujet:
Asie
langue:
Coréen
Texte intégral:
Journal of Korean Academy of Nursing
Année:
2009
Type:
Article
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