Journal of Society of Preventive Korean Medicine (대한예방한의학회지)

Society of Preventive Korean Medicine (대한예방한의학회)
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A Study on Health Insurance Coverage for Acupuncture Therapy in the Germany

독일에서의 침술 건강보험 급여화 사례 연구

  • Kim, Dongsu (KM Policy Research Center, Korea Institute of Oriental Medicine) ;
  • Park, Inhyo (School of Korean Medicine, Pusan National University) ;
  • Lim, Byungmook (Division of Humanities and Social Medicine, School of Korean Medicine, Pusan National University)
  • 김동수 (한국한의학연구원 한의학정책연구센터) ;
  • 박인효 (부산대학교 한의학전문대학원) ;
  • 임병묵 (부산대학교 한의학전문대학원 인문사회의학부)
  • Received : 2019.12.02
  • Accepted : 2019.12.26
  • Published : 2019.12.31
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Abstract

Background : Germany is the first country in the world to introduce modern systems of public health insurance, and the country which most widely uses complementary alternative medicine(CAM) in Europe. In early 21st century, a large evaluation studies were conducted to include acupuncture in health insurance payments, which were eventually decided. Objectives : This study is to investigate and analyze the process of public policy determination on insurance coverage for acupuncture in German health insurance system. Methods : We collected the data and information through the literature search and from the websites of German government departments and health insurance organizations. To obtain contextual information, German experts of health insurance and acupuncture clinical study were interviewed. Results : As use of acupuncture had been growing, German public health insurers wanted to evaluate the validity of acupuncture coverage and sponsored three evaluation projects for clinical effectiveness of acupuncture using randomized clinical trials, systematic reviews, and pragmatic trials from 2001 to 2005. For some pain condition, acupuncture was founded not to be effective than sham acupuncture, but more effective than standard care. The federal joint committee of health insurance decided to cover acupuncture for chronic pain of lumbar spine and chronic pain in at least one knee joint due to gonarthrosis. Conclusions : Considering the controversial subject matter in the process of acupuncture's health insurance coverage in Germany, expanding the benefits of Korean medicine in Korea needs to come up with ways to overcome the difficulties of placebo effect, standardization and lack of literature evidence.

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References

  1. D Hwang. The reform trends of German health insurance, Korea Legislation Research Institute 2013.
  2. YG Lee. The reform trends of German public health insurance, Health insurance &Policy 2007;6(4):69-89
  3. S Kim, Y Kim, H Jung. The current status and reform trends about health security of the main countries. Health Insurance Policy Research Institute. 2014.
  4. LM Kemppainen, TT Kemppainen, JA Reippainen, ST Salmenniemi, & PH Vuolanto, Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scandinavian journal of public health 2018;46(4):448-455. https://doi.org/10.1177/1403494817733869
  5. Cambrella website. https://cambrella.eu/home.php?il=174&l=deu
  6. I Park, D Kim. German Heilpraktiker system, its history and current status. Journal of Society of Preventive Korean Medicine 2018;22(3):45-60
  7. J Yoon, K Han, J Jeong, S Lee, I Jang. Review of the Large-Scale Clinical Researches on Acupuncture in Germany: ASH, ART, ARC, and GERAC. Korean Journal of Acupuncture 2013;30(1)21-26. https://doi.org/10.14406/acu.2013.30.1.021
  8. V Fonnebo. S Wiesener, T Falkenberg, G Hegyi, J Hok, P R Sarsina, Cambrella Work Package2-Legal status and regulation of CAM in Europe. The 7th Framework Programme of European Union Commision. 2012.
  9. National Development Institute of Korean Medicine. Guidebook on entry into Europe of Korean medicine doctor. 2017.
  10. BH Choi, YJ Shin. A Study on introduction of global budgeting to the national health insurance. Korea Institute for Health and Social Affairs 2003.
  11. E Mossialos & JL Grand, Health Care and Cost Containment in the European Union, Aldershot, 1999.
  12. K Trinczek. Problematik der Kostenerstattung fur Akupunkturbehandlungen auf Kassenschein. Forsch Komplementmed 2015;22:118-123
  13. Zusammenfassender Bericht des Arbeitsausschusses <> des Bundesausschussesder Arzte und Krankenkassen uber die Beratungen der Jahre 1999 und 2000 zur Bewertung der Akupunktur gemass $\S$ 135 Abs.1 SGB V, 22.01.2001.
  14. M Cummings. Modellvorhaben Akupunktur - a summary of the ART, ARC and GERAC trials. Acupuncture in Medicine 2009;27(1):26-30 https://doi.org/10.1136/aim.2008.000281
  15. K Limde, A Strng, A Hoppe, S Jurgens, W Weidenhammer, D Melchart. The programme for the evaluation of patient care with acupuncture (PEP-Ac) - a project sponsored by ten German social health insurance funds. ACUPUNCTURE IN MEDICINE 2006;24(Suppl):25-32. https://doi.org/10.1136/aim.24.Suppl.25
  16. Zusammenfassender Bericht des Unterausschusses <> des GemeinsamenBundesausschusses uber die Bewertung gemass $\S$135 Abs.1 SGB V der Korperakupunktur mit Nadeln ohne elektrische Stimulation bei chronischen Kopfschmerzen, chronischen LWS-Schmerzen und chronischen Schmerzen bei Osteoarthritis, 27.09.2007.
  17. Bekanntmachung eines Beschlusses des Gemeinsamen Bundesausschusses uber eine Anderungder Richtlinie Methoden vertragsarztliche Versorgung in Anlage I "Anerkannte UntersuchungsoderBehandlungsmethoden" und in Anlage II "Methoden, die nicht als vertragsarztliche Leistungen zu Lasten der Krankenkassen erbracht werden durfen": Akupunktur. Vom 18. April 2006/19. September 2006.
  18. Beschluss des Gemeinsamen Bundesausschuss vom 19.09.2006. Bekanntmachung eines Beschlussesdes Gemeinsamen Bundesausschusses uber eine Anderung der Richtlinie Methoden vertragsarztliche Versorgung in Anlage I "Anerkannte Untersuchungsoder Behandlungsmethoden" und in Anlage II "Methoden, die nicht als vertragsarztliche Leistungen zu Lasten der Krankenkassen erbracht werden durfen": Akupunktur. Vom 18. April 2006/19. September2006.
  19. D Melchart. Die Akupunktur in Deutschland heute - von Euphorie zur Ernuchterung. Forsch Komplementmed 2015;22:82-83
  20. "The Guardian. "Acupuncture for low back pain no longer recommended for NHS patients.". 2016.3.24. https://www.theguardian.com/science/2016/mar/24/acupuncture-for-low-back-pain-no-longer-recommended-for-nhs-patients"
  21. "Korea Institute of Oriental Medicine. Report of Korean Medical Doctors' Health Insurance Policy Awareness Survey. 2017."
  22. D Kim, B Lim, I Park, YU Lee. A case study on benefit coverage of complementary medicine in public health insurance by the referendum in Switzerland. Journal of Society of Preventive Korean Medicine 2017;21(3):1-10
  23. D Kim, SH Kwon, SH Chung, BT Ahn, B Lim. The Health Insurance system and the Quality Improvement Policies for Chinese Medicine in Taiwan. Journal of Society of Preventive Korean Medicine 2016;20(2):27-38.