병원약사 약제서비스의 업무량 상대가치 조사
Research on the Relative Value of Pharmaceutical Care Services Performed by Hospital Pharmacists
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초록
Background : It is necessary to systematically assess the appropriateness of the relative value for the hospital pharmacist’s service, which has never been revised since the introduction of the relative value of system in 2001. Methods : In this study, we surveyed the time spent and the relative value of workload for each service conducted by hospital pharmacists which are currently included in the list of National Health Insurance (NHI) benefits, and we also investigated the which services should be newly included in the NHI list. Results : Among 240 hospitals, 51 hospitals responded to the survey and the estimated relative values for 1-day dispensing were similar regardless of the patient setting (inpatient, outpatient, or discharged patient). The relative values for ‘aseptic compounding for chemotherapy’, ‘aseptic compounding for total parenteral nutrition’, ‘aseptic compounding for other injectables’, ‘nutrition support team consult’, ‘counseling for discharge medication’, ‘discharge medication reconciliation’ ‘counseling for optimal inhaler use’, ‘anticoagulation management services’, ‘transplant pharmaceutical care’, and ‘critical care pharmacy service’ were 2.8~38.2 times higher compared to that for ‘1-day dispensing for an inpatient.’ It was shown that ‘critical care pharmacy service’, ‘medication counseling to a discharged patient’, and ‘counseling for optimal inhaler use’ had priority in the NHI benefits listing. Conclusion : This study discovered a gap between the measured relative values reflecting actual workload and currently applied reimbursement, and identified which services have priority in NHI benefits listing. We hope that these results would help adjust the NHI insurance fees to reduce the gap and establish new fees for advanced clinical services.
Abstract
Background : It is necessary to systematically assess the appropriateness of the relative value for the hospital pharmacist’s service, which has never been revised since the introduction of the relative value of system in 2001. Methods : In this study, we surveyed the time spent and the relative value of workload for each service conducted by hospital pharmacists which are currently included in the list of National Health Insurance (NHI) benefits, and we also investigated the which services should be newly included in the NHI list. Results : Among 240 hospitals, 51 hospitals responded to the survey and the estimated relative values for 1-day dispensing were similar regardless of the patient setting (inpatient, outpatient, or discharged patient). The relative values for ‘aseptic compounding for chemotherapy’, ‘aseptic compounding for total parenteral nutrition’, ‘aseptic compounding for other injectables’, ‘nutrition support team consult’, ‘counseling for discharge medication’, ‘discharge medication reconciliation’ ‘counseling for optimal inhaler use’, ‘anticoagulation management services’, ‘transplant pharmaceutical care’, and ‘critical care pharmacy service’ were 2.8~38.2 times higher compared to that for ‘1-day dispensing for an inpatient.’ It was shown that ‘critical care pharmacy service’, ‘medication counseling to a discharged patient’, and ‘counseling for optimal inhaler use’ had priority in the NHI benefits listing. Conclusion : This study discovered a gap between the measured relative values reflecting actual workload and currently applied reimbursement, and identified which services have priority in NHI benefits listing. We hope that these results would help adjust the NHI insurance fees to reduce the gap and establish new fees for advanced clinical services.
참고문헌 (10)
- A Study on the Reorganization of Relative Value, "Shin YS", Health Insurance Review and Assessment Service & Korea Institute for Health and Social Affairs, ~, pp.Report No. G000ME4-2018-151 (2018)
- A Study on the Accounting Survey for the Reform of Relative Value, "Shin YS", Health Insurance Review and Assessment Service & Korea Institute for Health and Social Affairs, ~, pp.Report No: G000EV2-2019-150 (2019)
- "Overview of Health Insurance Fee System" (2020)[URL]
- Shin YS, "How to Improve the National Health Insurance Fee-for-Service Schedule", Health and Welfare Forum, 272, pp.39~52 (2019)
- Jo YH., "Establishment and Adjustment of Health Insurance Fees for Hospital Pharmacists (Conference Presentation)", 2019 Education Program for the Managers in Department of Hospital Pharmacy (2019)
- A Study on the Management Analysis and Systematization to Establish the Proper Health Insurance Fee for Community Pharmacy, "Kim JH", Inje University:Health Science Research Center, ~ (2002)
- Establishment of Management System for the Classification and Definition of Korean Medical Activities: Community Pharmacy, "Park IC", The Korean Pharmaceutical Association &Health Insurance Review and Assessment Service, 1~94 (2011)
- A Study on the Development of Relative Value by Workload for the Third Reorganization of Relative Value, "Park HK", Korea Institute for Pharmaceutical Policy Affairs & The Korean Pharmaceutical Association, 1~95 (2020)
- A plan to secure safe use of medications by strengthening pharmaceutical services in medical institutions, "Lee ES", Ministry of Health & Korean Society of Health-System Pharmacists, ~ (2017)
- Analysis of the Workload and Cost of the Department of Pharmacy in Hospital for calculating the relative value score, "Lee EK", Sookmyung Women’s University & Korean Society of Health-System Pharmacists, ~ (2009)