분만 수가 인상만으로 분만 인프라 붕괴를 막을 수 있을까?

Abstract

In an era of low fertility, the maternity infrastructure system has collapsed steeply and the number of obstetrically underserved areas has increased. To improve the maternity infrastructure, the Yoon Suk Yeol administration has announced the introduction of an essential medical support policy centered on introducing an additional delivery medical fee. The core of the essential medical policy for labor and delivery is the addition of regional medical fees, safety policy additional fees, and infectious disease-controll policy additional fees to the existing labor and delivery medical fees. The government's delivery medical additional fees will vary according region, with 200% increase in metropolitan cities, 300% increase in nonmetropolitan cities, and an additional 100% increase in the event of an infectious disease outbreak. After analyzing the government's plan to support additional fees, it is estimated that the total delivery expenses will be increased by Korean won (KRW) 236,619,748,266, and KRW 485,872,173 per maternity hospital. Even though this support plan is expected to help maintain maternity hospitals, this plan has limitations in small maternity hospitals in metropolitan cities and maternity hospitals for high-risk pregnant women. This is because the government's support policy is based on the "medical payment system by action," which is less effective in rural maternity hospitals with fewer deliveries and in training hospitals that mainly treat high-risk pregnant women rather than simple deliveries. Additionally, given the expected decline in the number of births in the future, it is estimated that the total delivery medical fees will steadily decline, as will the income per maternity hospital. To maintain a sustainable maternity infrastructure, it is essential to introduce the medical fees for operating a maternity delivery room that can be maintained, the medical fees for high-risk pregnancies, and various salary and protection support policies for obstetricians and nurses in addition to delivery medical fees.