• The Journal of the Korea Contents Association
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• v.19 no.3
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• pp.365-374
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• 2019

Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

• The Korean Society of Law and Medicine
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• v.12 no.1
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• pp.11-39
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• 2011

[ ${\S}27$ ]Abs. 3 das Gesuntheitsdienstgesetz (the Medical Service Act) in Korea lautet: Niemand in der Absicht, sich oder einem Dritten einen $Verm{\ddot{o}}gensvorteil$ zu verschaffen, der Medizininstitut bzw. dem Mediziner (die Medizinerin) den Patienten vorstellen, ${\ddot{u}}bweweisen$, verleiten oder einen anderen zu dieser Handlung anstiften darf, wie z.B. die Selbstbeteiligung des Patienten nach dem Krankenkassengesetz (the National Health Insurance Act) oder dem Gesetz ${\ddot{u}}ber$ Beistand der ${\ddot{a}}rztlicher$ Betreuung (the Medical Care Assistance Act) skontieren oder befreien, Geld offerieren oder dem Allgemeinheit das Verkehrswesen anbieten usw. Nach dem Wortlaut ist jedoch unklar, ob unter diese Vorschriften der Fall subsumiert werden kann, wenn eine Medizininstitut bzw. ein(e) Mediziner(in) in der Absicht, sich einen $Verm{\ddot{o}}gensvorteil$ zu verschaffen, sich den Patienten verleitet. Nach dem Korean Supreme Court ist eine Medizininstitut bzw. ein(e) Mediziner(in) nur dann das Subjekt der Verleitungshandlung, wenn sie bzw. er ein Mittel gegen fairen oder $ordungsm{\ddot{a}}{\beta}ien$ Medizinmarkt verwendet oder dem Patienten eine ${\ddot{a}}rztlich$ rechtswidrige Behandlung (z.B. einen rechtswidrigen Schwangerschaftsabbruch) verspricht. In diesem Beitrag wird dagegen die Auffassung mittels der teleologischen Reduktion vertritt und argumentiert, dass ein ${\ddot{a}}rztlich$ rechtswidriges Behandlung nach dem Rechtsgut und dem Normzweck unter ${\S}27$ Abs. 3 das Gesuntheitsdienstgesetz nicht subsumiert werden, sondern allein nach eigenem Unrecht bestraft werden kann.

• Health Policy and Management
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• v.16 no.1
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• pp.73-94
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• 2006

This study was carried out to show how the Analytic Hierarchy Process technique could be used in setting the priority among selected diseases to increase the range of health insurance benefit. Thirty experts, including doctors (group1), experts for preventive medicine or public health(group2), and representatives of the insured(group 3), participated in the study panel that is conducted for priority setting. They were asked to evaluate the priorities among 6 selected criteria and then 42 selected diseases. The results were as follows; First, representatives of the insured think that the magnitude of out-of-pocket payment should have high priority while doctors think that effectiveness of treatment should have high priority. Second, all experts think that catastrophic diseases such as malignant neoplasm, major heart disease, and cerebral vascular disease should have high priority in health insurance coverage even though there is little difference among groups. These results can be useful to establish a systematic strategy for expanding health insurance benefit package.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.384-389
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• 2017

This study was conducted to investigate the patient and hospital characteristics that affect receiving and non-receiving blood transfusion for hepatoma embolization. We analyzed data describing 757 patients of the Health Insurance Review and Assessment Service's 2011 claims sample data. Chi-squared and logistic regression analysis was performed using STATA 12.0. Logistic regression analysis revealed that anemia (Odds ratio (OR)=9.544, 95% confidence interval (CI)=3.362-27.097), female (OR=2.186, Cl=l.240-3.854), age 65-74 (OR=0.506, CI=0.269-0.952), 1000 over bed (OR=0.053, CI=0.018-0.151), out-department (OR=0.211, CI=0.081-0.551), and 700-999 bed (OR=0.105, CI=0.036-0.304) were significant predictors of blood transfusion in tertiary hospitals. Additionally, anemia (OR=69.681, CI=8.545-568.246) and aged 75 or over (OR=0.112, CI=0.025-0.506) were significant predictors of blood transfusion in general hospitals. This research would expected to cost effective and preliminary data of blood transfusion quality.

• The Korean Society of Law and Medicine
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• v.21 no.3
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• pp.3-33
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• 2020

Telemedicine can be defined as "medical activities performed remotely by medical personnel using information and communication technology." So far, many scholars in Korea have understood that only telemedicine between medical personnel is allowed and telemedicine between medical personnel and patients is prohibited based on Article 34 of Medical Service Act. However, Article 34 is only a restriction on the performing place of medical profession, not a prohibition on telemedicine itself. And, there are no regulations prohibiting telemedicine under the korean medical law. So, it is difficult to say that telemedicine is generally prohibited under the korean medical law, apart from the health insurance medical treatment benefit standards. However, there is controversy in interpretation regarding the meaning of "direct diagnosis" in Articles 17 and 17-2 of Medical Service Act. The Constitutional Court of Korea interpreted this as "face-to-face diagnosis", while the Supreme Court of Korea interpreted it as "self diagnosis". In light of the dictionary meaning of 'direct' and the interpretation of related medical law regulations, I think the Supreme Court's interpretation is valid. Although "direct diagnosis" does not mean "face-to-face diagnosis", the concept of "diagnosis" implies "principle of face-to-face diagnosis". In addition, "non-face-to-face diagnosis" are only allowed to supplement "face-to-face diagnosis", so the problems caused by "non-face-to-face diagnosis" can be fully overcome. In the end, the limit of telemedicine is how faithful the diagnosis was.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.203-210
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• 2018

The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.141-169
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• 2022

Article 34 of 'Medical Service Act' of Korea provides telemedicine service between medical personnel. Telemedicine between medical personnel and patients, therefor, in principle, is not recongnized. Increasing demand for telemedicine fueled by COVID-19 pandemic and accumulation of telemedicine experience lead a change in stubborn opposition of the medical community, tenuous though it may be. This article focuses on the telemedicine legislation in France, which can be used as a reference for the telemedicine legislation premised on telemedicine between medical personnel and patients. The legislation stipulates the concept, types, and conditions of telemedicine performance through 'Code de la santé publique'. The principle that telemedicine shall be performed alternately with direct medical treatment to a patient and details relating to such telemedicine performance as telemedicine costs, medical fees, and telemedicine equipment support are stipulated through an agreement between the medical community and health insurance organizations. From this point, the implications for our legal system were presented.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.192-197
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• 2009

Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.81-109
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• 2021

This paper review about the relationship between the prohibition against medical refusal and the principle of private autonomy in medical contracts. The obligation to this Prohibition in Medical Law does not restrict the liberty of contracting a medical contract. On the other hand, the prohibition limits the freedom to terminate medical contracts. Medical contracts can be terminated if the trust between doctors and patients is vanished. However certain restrictions should be placed on termination of the medical contract, because termination of the contract should not be detrimental to patients' health. According to the current medical law the medical contract is to be enforced in principle and can be revoked only with justifiable reason. At the Civil Code on Medical Contracts the freedom to terminate the medical contract is permitted, but this paper suggests the restrictions of the revocation under certain conditions. The Criminal Punishment Regulations against medical refusal should be removed. Refusal the provide medical service should be regulated by administrative sanctions under the National Health Insurance Act's obligation.

• Journal of Preventive Medicine and Public Health
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• v.26 no.1 s.41
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• pp.1-19
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• 1993

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.