우리나라와 일본의 병원약사와 관련된 업무에 대한 수가 비교

Abstract

Background : Currently, the pharmacists at hospitals in Korea provide professional and diverse pharmaceutical care services. However, the service fee covered by national health insurance (NHI) is limited to the traditional dispensing and managing of medication. In Japan, with a similar health insurance system to Korea, health insurance fees for pharmaceutical care services are rewarded in various types. We aimed to compare the unit price and types of reimbursement activity covered by NHI between Korea and Japan. Methods : The 2020 medical fee tables from NHI in Korea and Japan were examined and the unit price and condition were extracted for analysis. The insurance fee of Japan was converted into Korean won using the Purchasing-Power-Parities (PPP) exchange rate. We set various cases for comparison (1-day dispensing for peroral and external use medication and aseptic compounding) in inpatient and outpatient settings. Results : In Japan, various fees were awarded for pharmacists’ clinical pharmaceutical care activities besides traditional dispensing and promoting participation in multidisciplinary team activities. Compared to Japan, the level of health insurance fees in Korea was 70–73%, 47–57%, and 19–31% for 1-day dispensing to inpatients, outpatients, and discharge patients, respectively. For aseptic compounding for three-drug chemotherapy regimens and parenteral nutrition, the levels were estimated at 103–116% and 122%, respectively. Conclusion : The hospital pharmacists’ services fees in Korea were lower than those in Japan for traditional dispensing activities. There were more types of health insurance fees in Japan, and the terms and conditions that must be met to be awarded were very specific.