The purpose of this study is to compare and analyse the fixed-rate payment and fee-for-service payment at a convalescent hospital (1st class of additional manpower) based on the billing statements of inpatients from January to June 2020, a period of 6 months. A total of 1,898 cases of information were extracted and among them, 1,799 cases of the fixed-rate payments were analysed.
The findings were as follows:
First, analysis based on the general characteristics and the distribution of treatment characteristics in the patient groups was done. The intermediate-medical demand group had the most cases with 720 patients (40.0%), the high-medical demand group had 673 patients (37.4%), and the low-medical demand group had 300 patients (16.7%), the group of selective hospitalization had 76 patients (4.2%), and 30 patients (1.7%) was in the highest-medical demand.
Second, as a result of comparing the fixed-rate and fee-for-service payment according to age, those who were at the age of 66 to 75 recorded the highest for the fixed-rate payment(p〈0.05), and patients under the age of 65 recorded the highest for the fee-for-service payment(p〈0.001).
Third, the study compared and analysed the fixed-rate and fee-for-service payment in the patient groups and found that the fixed-rate payment was higher than the fee-for-service payment in the high-, middle- and low-medical demand groups(p〈0.001). However, in the highest-medical demand and the group of selective hospitalisation, the fee-for-service payment was higher than fixed-rate payment(p〈0.001).
Finally, the number of diseases was one of factors that affected both the fixed-rate and the fee-for-service payment. The fixed-rate payment was highest when the number of diseases was less than 5. In comparison, the fee-for-service payment increased according to the number of diseases.
Based on these findings, since the characteristics of inpatients are different for each convalescent hospital, it is necessary to set up a detailed customized policy based on convalescent hospital functionality rather than a unified policy and also should take into account the policy for patients at the age of under 65.