Je Uiemo, Han Woong Kyu, Jeong Hee-Kyo, Lee Hankil, Lee Kwang Suk, Kang Sung Ku, Kwon Byeong-Ju, Kuh Sung-Uk
Department of Medical Device Engineering and Management, Yonsei University College of Medicine, Seoul, Korea.
Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
Investig Clin Urol. 2025 Jan;66(1):87-96. doi: 10.4111/icu.20240289.
This study aims to develop and implement an economic evaluation using a micro-costing approach to provide a precise and transparent analysis of the direct costs of cystoscopic procedures in Korean hospitals. The study seeks to identify key cost components and evaluate whether current reimbursement rates accurately reflect these direct costs.
Significant variations in cost items were identified across different studies. An economic evaluation was conducted using a micro-costing methodology for the cost analysis of cystoscopic procedures, developed through literature review, data collection from studies, and expert consultations.
Gangnam Severance Hospital (GSH) performed 2,188 cystoscopic procedures, including 1,847 cystoscopies and 341 JJ stent removals, with average costs of $100.8 and $110.6, respectively. At National Health Insurance Service Ilsan Hospital (NHIMC), 1,463 procedures were performed, including 1,167 cystoscopies and 296 JJ stent removals, with average costs of $119.2 and $125.3. Cystoscopy costs at GSH were driven by reprocessing ($45.8, 45.4%) and equipment ($33.1, 32.9%), while NHIMC's were $52.5 (44.0%) for equipment and $48.7 (40.8%) for reprocessing. Both hospitals incurred financial losses, with NHIS (National Health Insurance Service) covering only about 71.7% and 60.6% of costs for cystoscopy, and 71.0% and 62.7% for JJ stent removal.
The significant discrepancy between HIRA (Health Insurance Review & Assessment Service)'s estimated costs and those identified here suggests that current fees for cystoscopic procedures may be underestimated and require reassessment. Given the results, reevaluating these rates is essential to ensure fair compensation for healthcare providers and to deliver optimal patient care.
本研究旨在采用微观成本核算方法开展并实施一项经济评估，以对韩国医院膀胱镜检查程序的直接成本进行精确且透明的分析。该研究旨在确定关键成本组成部分，并评估当前的报销率是否准确反映了这些直接成本。
在不同研究中发现成本项目存在显著差异。通过文献综述、研究数据收集及专家咨询，采用微观成本核算方法对膀胱镜检查程序进行成本分析，从而开展经济评估。
江南Severance医院（GSH）进行了2188例膀胱镜检查程序，包括1847例膀胱镜检查和341例输尿管支架取出术，平均成本分别为100.8美元和110.6美元。在韩国国民健康保险公团一山医院（NHIMC），进行了1463例程序，包括1167例膀胱镜检查和296例输尿管支架取出术，平均成本分别为119.2美元和125.3美元。GSH的膀胱镜检查成本由再处理（45.8美元，45.4%）和设备（33.1美元，32.9%）驱动，而NHIMC的设备成本为52.5美元（44.0%），再处理成本为48.7美元（40.8%）。两家医院均出现财务亏损，国民健康保险公团（NHIS）仅支付了膀胱镜检查成本的约71.7%和60.6%，输尿管支架取出术成本的71.0%和62.7%。
健康保险审查与评估服务机构（HIRA）估计成本与本研究确定的成本之间存在显著差异，这表明当前膀胱镜检查程序的费用可能被低估，需要重新评估。鉴于这些结果，重新评估这些费率对于确保医疗服务提供者获得公平补偿以及提供最佳患者护理至关重要。
