• Title/Summary/Keyword: 건강보험법

Search Result 139, Processing Time 0.042 seconds

Probleme nach geltendem Recht „Richtlinien für die Verwendung von Gesundheitsdaten" ('보건의료 데이터 활용 가이드라인'의 현행법상 문제점)

  • Lee, Seok-Bae
    • The Korean Society of Law and Medicine
    • /
    • v.22 no.4
    • /
    • pp.3-35
    • /
    • 2021
  • Inmitten der Flut der privaten und öffentlichen Information gilt die riesige Informationsmenge als Schlüsselressource im Zeitalter der 4. industriellen Revolution, repräsentiert durch Big-Data. Das Interesse an diesen wächst weltweit. Es gibt eine aktive Diskussion darüber, wie man Daten sichert und akkumuliert und wie man die gesammelten Daten sicher und effektiv nutzt. Gesundheitsdaten werden vor allem als die wertvollste Ressource bewertet, für die Big-DataTechnologie eingesetzt wird. Um Gesundheitsdaten sinnvoll zu nutzen, müssen verteilte Gesundheitsdaten integriert und den Benutzern in einer Form zur Verfügung gestellt werden, die für Forschung oder Inspektion verwendet werden kann. In einer Situation, in der große Länder um den Aufbau bzw. die Führung der Datenwirtschaft konkurrieren, wurden im August 2020 auch in Südkorea die sog. „3-Daten-Gesetze" geändert, die das Datenschutzgesetz(DSG) enthälten. Das DSG führte das Konzept der pseudonymen Informationen ein und baute eine Rechtsgrundlage für deren Verwendung auf. Als Folgemaßnahme kündigte die, Kommission für den Schutz personenbezogener Daten(Personal Information Protection Commission: PIPC)' die „Richtlinien für die Bahandlung mit pseudonymen Informationen" und, Ministerium für Gesundheit und Wohlfahrt' die „Richtlinien für die Verwendung von Gesundheitsdaten" an. Gesundheitsdaten stehen direkt in Zusammenhang mit Leben und Körper des Menschen und damit enthalten viele sensible Daten. Es handelt sich also um ein System, das aus einer vorsichtigeren und konservativeren Sicht unter der Voraussetzung verwendet werden kann, personenbezogene Daten sicherer zu schützen. Um die Hauptinhalte der „Richtlinien für Verwendung von Gesundheitsdaten" zu analysieren, überprüften wir zunächst die Hauptinhalte des überarbeiteten DSG. Danach durch die Analyse der wesentlichen Inhalte der „Richtlinien für Verwendung von Gesundheitsdaten" wurden Probleme wie Konflikte mit anderen Gesetzen und Verbesserungsmaßnahmen überprüft.

A Study on the Local Governments' Autonomous Laws Regulating Social Insurance Premium for Medical Security (의료보장을 위한 지방정부의 사회보험료 지원 자치법규에 관한 고찰)

  • Kim, Jesun
    • The Korean Society of Law and Medicine
    • /
    • v.20 no.1
    • /
    • pp.203-242
    • /
    • 2019
  • Since 2006, local governments in Korea have been providing premiums for social insurance, such as the National Health Insurance System, for the health care of local residents. The purpose of this study is to analyze the content of self-governing legislation that defines these policies. The method of conducting the research was based on the articles of the ordinance related to the 'public health insurance premium' of the self-governing statutes published on the website of the National Law Information Center. As of May 2019, 201 municipalities have enacted ordinances to support public health insurance premiums. In the case of state local governments, 8 out of 17 were found, and in the case of basic local governments, 193 out of 226. The constitution of the ordinance consisted of purpose, time of enactment, type of social insurance premium, object of social insurance premium, amount of social insurance premium support, method and process of social insurance premium support, time of social insurance premium support. This study analyzed contents of these articles. Finally, this study presented issues that could be controversial from the policy and legal viewpoints and suggestions for improvement.

법령과 고시-건설산업기본법 시행령 일부 개정

  • Korea Mechanical Construction Contractors Association
    • 월간 기계설비
    • /
    • no.2 s.211
    • /
    • pp.38-42
    • /
    • 2008
  • 건설산업기본법시행령.시행규칙이 지난 해 12월 28일 개정되어 1월 1일부터 시행에 들어갔다. 이번에 개정된 시행령은 기계설비공사업 업역 확대 및 국민연금, 건강보험료 비용정산 등을 주요 내용으로 개정되었다. 대한설비건설협회는 시행령.시행규칙 개정 과정에서 업역확대를 주목표로 설정하고 신규 사업분야인 시스템에어컨 설치공사, 지열냉난방설치공사, 자동제어 분야에서 전기.통신과 업역다툼이 있었던 자동원격검침 설비공사, 지능형 제어시스템 설치공사 등을 기계설비공사업역에 추가시켰다. 이로써 지난 해 건산법 개정 시 기계설비만 겸업제한 폐지를 4년 유예시킨 성과에 버금가는 성과를 거두었다. 또한 대한설비건설협회는 국민연금, 건강보험료의 비용 정산을 민간공사에도 도입될 수 있도록 끊임없이 건의하여 이번에 개정됨으로써 회원사의 보험료 납부 부담을 줄일 수 있게 되었다. 건산법 시행령·시행규칙의 주요 개정 내용 및 설비건설업과 관련한 신.구조문 대비표는 다음과 같다.

  • PDF

A Study How to Decide the Priority on choosing between National Health Insurance and Automobile Insurance In Korea -Focused on medical expenses of the Insured's own bodily Injury Coverage- (건강보험과 자동차보험의 선택적 우선적용에 대한 고찰 -경과실 자기신체피해 교통사고를 중심으로-)

  • Song, Ki-Min;Choi, Ho-Young;Kim, Jin-Hyun
    • The Korean Society of Law and Medicine
    • /
    • v.10 no.2
    • /
    • pp.287-307
    • /
    • 2009
  • A person is injured in car accident caused by his/her slight negligence except he / she causes accident by his / her willfulness or gross negligence. Because the National Health Insurance Corporation (hereinafter called "Corporation") shall not provide any insurance benefit "when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident" referred to in Article 48 (1) 1 of the National Health Insurance Act. So, if he / she is insured by his / her own bodily injury coverage, he / she can be compensated for his / her medical expenses. The injured have the rights to file either National Health Insurance claim and Automobile Insurance claim but there is no clear and definite adjustment clause. The claim disputes between National Health Insurance (hereinafter called "NHI") and Automobile Insurance (hereinafter called "AI") in the own bodily injury coverage makes some problems. Firstly, there are some differences in co-payments which he / she chooses between NHI and AI. Profit per a patient is higher in the NHI than in the AI. Secondly, it can provoke criticism that people shall unnecessarily pay double contributions. Lastly, it can raise moral hazards. For example, if he / she can cover the compensations when the insured receives the compensations from his / her insurer, the Corporation can be claimed by medical care institution payment of the health care benefit costs. In conclusion, first of all, to improve the national health and preserve the insured's rights the Corporation shall keep notice these facts.

  • PDF

A Study on the Dental Hygienist's Awareness on the Elderly Long-Term Care Insurance System (치과위생사의 노인장기요양보험제도에 대한 인식도 연구)

  • Park, Jeong-Ran;Kwon, Sun-Hwa
    • Journal of dental hygiene science
    • /
    • v.9 no.3
    • /
    • pp.279-286
    • /
    • 2009
  • This research targeted 253 dental hygienists who are working in parts of the South Gyeongnam Province to identify their Degree of Recognition on the Elderly Long-term Care Insurance System executed on July 1,2008 according to their awareness. The following conclusions were obtained. 1. Experience in managing elderly patients' oral cavity and specialized education on the elderly patients while studying dental hygiene (department) manifested statically significant difference with the appropriate age of the Long-term care worker(p<0.01, p<0.05). Moreover, there was significant difference in the level of understanding on the Elderly Long-term Care Insurance System depending on the experience of volunteering and on whether they got specialized education on the elderly patients while working(p<0.01). 2. There was significant difference in the awareness of the Elderly Long-term Care Insurance System following interest in the health of the elderly patients' oral cavity(p<0.05, p<0.01, p<0.001).

  • PDF

Civil Law Study on the Arbitrary Uninsured Medical Benefits (임의비급여 진료행위에 관한 민사법적 검토)

  • Bae, Byungil
    • The Korean Society of Law and Medicine
    • /
    • v.18 no.2
    • /
    • pp.75-103
    • /
    • 2017
  • There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

  • PDF

Constitutional Limits of the Medical Fee Payment System and the Unconstitutionality of Fixed Payment System (진료수가제도의 헌법적 한계와 정액수가제의 위헌성 -헌법재판소 2020. 4. 23. 선고 2017헌마103 결정을 중심으로-)

  • Hyun, Doo-youn
    • The Korean Society of Law and Medicine
    • /
    • v.21 no.1
    • /
    • pp.69-105
    • /
    • 2020
  • In the health care system, medical fee payment is a very important and basic factor. The National Health Insurance Act adopted a contract system, and the content of the contract is to be determined the unit price per relative value scale. Accordingly, in the National Health Insurance system, the costs of health care benefits are adjusted each year according to inflation or changes in economic conditions. On the other hand, in the Medical Care Assistance system, the Medical Care Assistance Act does not prescribe the method of determining the medical payment, and all matters are delegated to the Minister of Health and Welfare. Accordingly, the Minister has adopted a fixed-payment system for hemodialysis treatment since 2001. A constitutional petition was filed in 2017 against this fixed-payment system, and the Constitutional Court rejected the petition in 2020. In this study, we examine the meaning and content of the medical fee payment system, focusing on the above constitutional petition case, and present three principles as constitutional limits on the system. The first of its principles is the principle of legality, the second is the principle of prohibition of comprehensive delegation, and the third is the principle of proportionality. From that point of view, There are many unconstitutional elements in the fixed-payment system on hemodialysis.

Differences of Obstetric Complications and Clinical Characteristics between Autism Spectrum Disorder and Intellectual Disability (자폐스펙트럼장애와 지적 장애의 산과적 합병증 및 임상적 특성의 차이)

  • Lee, Seul Bee;Kim, Ji Yong;Chung, Hee Jung;Kim, Seong Woo;Im, Woo Young;Song, Jung-Eun
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.24 no.2
    • /
    • pp.165-173
    • /
    • 2016
  • Objectives : Since the awareness of autism spectrum disorders(ASD) is growing, as a result, it is increasing numbers of infants and toddlers being referred to specialized clinics for a differential diagnosis and the importance of early autism spectrum disorders detection is emphasized. This study is to know the difference between ASD and intellectual disability(ID) from comparison of the demographics, clinical characters and obstetric complications. Methods : The participants are 816 toddlers who visited the developmental delay clinic(DDC) in National Health Insurance Ilsan hospital. The number of toddlers diagnosed as ASD and ID was 324 and 492. 75 toddlers out of 114 who returned to DDC were diagnosed as ID at the first visit but 7 of them had changed diagnosis to ASD at the second visit. After compared ASD with ID from the first visit, we analyzed characters of toddlers who had the changed diagnosis to ASD at the second visit. Results : As a result, the comparison between ASD and ID at the first visit shows that the boys have higher ratio, lower obstetric complication and lower language assessment score in ASD. The toddlers who had the changed diagnosis at the second visit were all boys and they had more cases of family history of developmental delay and had lower score of receptive language developmental quotient. Conclusions : These findings suggest that sex, language characteristics and obstetric complication could be useful in the early detection of ASD.

Current State and the Future Tasks of Home Visit Nursing Care in South Korea (우리나라 가정방문간호의 현황과 향후 과제)

  • Park, Eunok
    • Journal of agricultural medicine and community health
    • /
    • v.44 no.1
    • /
    • pp.28-38
    • /
    • 2019
  • Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

A Study on Medical Fee System of the convalescent hospital -Focused on the case of patient group adjustment - (요양병원 수가제도에 대한 소고 -환자군 조정 판결을 중심으로 -)

  • Kwon, Hye Ok
    • The Korean Society of Law and Medicine
    • /
    • v.18 no.2
    • /
    • pp.195-218
    • /
    • 2017
  • The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

  • PDF