포괄수가지불제도에서의 효율적 병원경영을 위한 사례관리 의사결정지원시스템 모형 개발- 제왕절개분만군을 대상으로 -
Development of decision support system for case management under the DRG PPS(prospective payment system)- for the case of cesarean section -
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: 포괄수가지불제도하에서의 사례관리의사결정지원시스템교신저자 : 송 미라주소 : (우)135-080 서울시 강남구 역삼동 831-37전화번호 : (02)3452-1636 Fax번호 : (02)3452-3428 E-mail : mrsong@urscope.co.kr
Abstract
Recently, we have experienced with various changes in the health insurance. Korean government is implementing the prospective payment system(PPS) as a pilot project to reduce medical expenditure. Case management is an effective way to reduce costs, while not sacrificing quality of service, under the PPS. In this study, the integrated decision support system(DSS) for case management was presented to support two case management activities ; utilization management and discharge planning. This system can be used in three ways ; prospective, concurrent, and retrospective management. By monitoring cases from medical record database, the DSS provides basic patient information, payment information, medical service information to the case manager.In the future, data warehouse should be introduced to integrate various databases related to case management and to improve quality of information produced by the DSS.