Hourly wages of physicians within medical fees based on the Korean relative value unit system
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초록
Background/Aims: It is difficult to reach a social agreement on the appropriate level of compensation for professionals. This study was performed to examine the physician fee embedded in the relative value unit (RVU) system in comparison with the Korean hourly minimum wage. Methods: The Health Insurance Service Price and the Korean Classification of Procedural Terminology were used to obtain the hourly wages of physicians for designated health care services. In addition, the physician fee schedule at the United States Centers for Medicare and Medicaid Services and the Organisation for Economic Co-operation and Development (OECD) report on minimal wage were used. Health care service fees were selected based on laboratory, pathology, imaging, and procedure codes as well as examination fees. For calculation of physician labor costs per hour, physician workload × conversion factor was divided by the time involved. To calculate the proportion of physician labor fee in the total fee, the physician workload RVU for each service fee was divided by the total RVU. Results: A total of 27 physician fee codes were selected. Compared to the Korean hourly minimum wage in 2015, the average physician wages were greater by 2.80- fold for primary care and by 3.05-fold for tertiary care. The mean proportion of physician labor cost in the total cost was 0.19, which was significantly lower than that of corresponding procedures in the United States RVU (mean, 0.48). Conclusions: The average Korean physician wages compared to the hourly minimum wage were disproportionately low compared to the USA and other reference OECD countries.
Abstract
Background/Aims: It is difficult to reach a social agreement on the appropriate level of compensation for professionals. This study was performed to examine the physician fee embedded in the relative value unit (RVU) system in comparison with the Korean hourly minimum wage. Methods: The Health Insurance Service Price and the Korean Classification of Procedural Terminology were used to obtain the hourly wages of physicians for designated health care services. In addition, the physician fee schedule at the United States Centers for Medicare and Medicaid Services and the Organisation for Economic Co-operation and Development (OECD) report on minimal wage were used. Health care service fees were selected based on laboratory, pathology, imaging, and procedure codes as well as examination fees. For calculation of physician labor costs per hour, physician workload × conversion factor was divided by the time involved. To calculate the proportion of physician labor fee in the total fee, the physician workload RVU for each service fee was divided by the total RVU. Results: A total of 27 physician fee codes were selected. Compared to the Korean hourly minimum wage in 2015, the average physician wages were greater by 2.80- fold for primary care and by 3.05-fold for tertiary care. The mean proportion of physician labor cost in the total cost was 0.19, which was significantly lower than that of corresponding procedures in the United States RVU (mean, 0.48). Conclusions: The average Korean physician wages compared to the hourly minimum wage were disproportionately low compared to the USA and other reference OECD countries.
참고문헌 (23)
- 강명신, "Sustainability of Korean National Health Insurance", Journal of Korean Medical Science, 27, pp.21~24 (2012), 대한의학회[DOI]
- Jeong HS, "Korea’s National Health Insurance: lessons from the past three decades", Health Aff(Millwood), 30, pp.136~144 (2011)
- Kwon S, "Thirty years of national health insurance in South Korea : lessons for achieving universal health care coverage", Health Policy Plan, 24, pp.63~71 (2009)
- Flynn ML, "Health care financing in Korea : private market dilemmas for a developing nation", J Public Health Policy, 11, pp.238~253 (1990)
- Soe SR, "Satisfaction survey of national health insurance, 2008" (2008), National Health Insurance Corporation
- Lee HY, "Job satisfaction and trust in Health Insurance Review Agency among Korean physicians", Health Policy, 87, pp.249~257 (2008)
- DeVoe J, "Does career dissatisfaction affect the ability of family physicians to deliver high-quality patient care", J Fam Pract, 51, pp.223~228 (2002)
- Haas JS, "Physician discontent : a barometer of change and need for intervention", J Gen Intern Med, 16, pp.496~497 (2001)
- Zuger A, "Dissatisfaction with medical practice", N Engl J Med, 350, pp.69~75 (2004)
- "The Korean Classification of Procedural Terminology 2017" (2017)[URL]
- "Physician Free Schedule 2017" (2018)[URL]
- "Real minimum wages 2017" (2019)[URL]
- Baadh A, "The relative value unit : history, current use, and controversies", Curr Probl Diagn Radiol, 45, pp.128~132 (2016)
- Hsiao WC, "Resource-based relative values : an overview", JAMA, 260, pp.2347~2353 (1988)
- Beck DE, "Physician coding and reimbursement", Ochsner J, 7, pp.8~15 (2007)
- 강길원, "건강보험 상대가치 개정 연구의 성과와 한계", 보건행정학회지, 17(3), pp.1~25 (2007), 한국보건행정학회
- Tufano J, "Effects of compensation method on physician behaviors", Am J Manag Care, 7, pp.363~373 (2001)
- Ebell MH, "Future salary and US residency fill rate revisited", JAMA, 300, pp.1131~1132 (2008)
- Palmeri M, "Economic impact of a primary care career : a harsh reality for medical students and the nation", Acad Med, 85, pp.1692~1697 (2010)
- Irving G, "International variations in primary care physician consultation time : a systematic review of 67 countries", BMJ Open, 7, pp.e017902~ (2017)
- "Medicare Benefits Schedule" (2018)[URL]
- "Bundesarztregister" (2018)[URL]
- "Classification commune des actes médicaux" (2019)[URL]