• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.83-93
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• 2016

Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.45-72
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• 2012

The National Health Insurance Corporation has been retrieving from health care providers the payments made to them by insured patients as a result of the health care providers' arbitrary denial of coverage under the National Health Insurance, and has been disbursing such retrieved monies back to the patients, pursuant to Article 57, Sections 1 and 4 of the National Health Insurance Act. However, such practice is an application of the law that lacks legal exactitude. Another problem with such practice is that there is no legal provision under any laws or notices that expressly prohibits arbitrary denial of coverage. A legislative solution, therefore, is called for to address these issues.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.37-68
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• 2007

Health insurance has gone far toward solving Korea's health related problems through thirty years. Health Insurance as social security system has a role of national system to secure national health. But there are many problems in health insurance. There is a dispute about many issues, coverage of health security, compulsory appointment of health insurance organization, coverage and level of health insurance benefit, decisionmaking right of health insurance price, examination of health insurance etc. Generally, the opinion for health insurance policy to be leaded by nation sets against the opinion to be leaded by private sector. It is necessary to study politics of law, constitute law and comparative law for rational solving these problems. If desirable setting of health law system can be made, legal system must be set during a long time and be discussed synthetically in different standpoint.

• The Journal of the Korea Contents Association
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• v.13 no.12
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• pp.530-539
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• 2013

It is needed to provide a supplicated and standardized training program for hospital coordinators to boost their competencies as professionals. The purpose of this study was to propose a standardized training program for hospital coordinators especially trained at private institutions. Using DACUM method, with 11 professionals, we first developed competencies required for hospital coordinators. They were service mind, attitude, MOT(Moment of Truth) & phone-call etiquette, communication skill, customer behavior, basic medical terminology, insurance, computer skills, etc. Finally, we proposed a standardized training program for hospital coordinators which covers 16 subject areas.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.26-34
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• 2018

Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.3
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• pp.193-200
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• 2020

Purpose: To investigate the relationship between dementia and complete tooth loss on both sides or one side using large demographic data. Materials and methods: A retrospective cohort study was designed using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) which was established for people over the age of 60. The experimental group was the complete edentulous cohort, which had a history of treatment for national health insurance covered complete denture on both sides or one side from July 1, 2012 to December 31, 2013. And the control group was the dentulous cohort, which had a history of conservative dental treatment for the same period. All subjects had no history of diagnosis or treatment of dementia during this time. These cohorts were matched 1:1 by age, gender, and place of residence according to the propensity score matching method. Then the incidence of dementia was compared between these cohorts. Results: Compared with those groups, the incidence of dementia was significantly higher in the experimental group (12.13%) than in the control group (9.74%) (P<.05). No clear association between other factors has been identified. Conclusion: The analysis of large-scale demographic data shows that the incidence of dementia is high in complete edentulous patients on both sides or one side.

• The Korean Society of Law and Medicine
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• v.23 no.4
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• pp.3-28
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• 2022

Recently, the targets and clauses of negotiation between 'National Health Insurance Service (NHIS)' and Pharmaceutical companies has been expanded. Due to newly adopted 'Quality management clause', 'Compulsory supply maintenance clause' and 'Penalty for breach of contract clause', not only 'Ministry of Health and Wellfare (MOHW)'s 'drug listing' and 'Price cap' announcement, but also 'negotiation between NHIS and pharmaceutical companies' can be a legal sanction to the suppliers. Once secretary of MOHW order NHIS to negotiate with pharmaceutical company, NHIS notify this order to the company and enter into the negotiation. 'The order' exists in the public domain between the government (MOHW) and public institutions (NHIS) and does not constrain the legal rights of companies (Therefore companies cannot pile a lawsuit about the order). However, 'the notice' or 'negotiation' is an act which has a counterpart, can be a target of administrative litigation if the company get some disadvantages from the talks. Negotiations can be divided into four types according to "the target (whether it is listed on the insurance benefit list)" and "the purpose (whether the target is price or conditional)." In particular, negotiations on listed drugs, whose goal is to set unfavorable conditions for companies, can be illegal if there is no price. So we need to consider compensation for the company as an incentive to negotiate.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.9-35
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• 2007

The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.

• The Korean Society of Law and Medicine
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• v.22 no.1
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• pp.57-90
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• 2021

Telehealth has been a hotly debated health policy issue in South Korea, mostly because the medical community - especially primary care practitioners - have strongly opposed it. As a result, telehealth has remained forbidden under law. However, the temporary permission of telehealth in Korea, as well as its exploding use in other countries, all in response to COVID-19, is re-igniting the discussion on telehealth in Korea. This article explores general legal issues that may arise if and when telehealth is fully implemented in Korea. The article's analysis shows that legislative changes are necessary to allow reimbursement of telehealth as well as remote purchase of medicine. The article also advocates introducing new evidentiary rules to curtail covert recording of telehealth sessions. On the other hand, additional legislation is probably not necessary to address the medical liability of physicians practicing telehealth or to adress much-discussed privacy issues. The existing laws in those domains are already robust enough to operate without much difficulty in the context of telehealth too.

• Journal of the Korea Society of Computer and Information
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• v.26 no.11
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• pp.201-208
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• 2021

The purpose of this study is to investigate factors affecting unmet medical care in elderly hypertensive patients. The purpose of this study was to understand the reasons for unmet medical care in elderly hypertensive patients over 65 years of age and to identify the characteristics of each type to improve the medical use system and to contribute to policy making so that unmet medical care does not occur. Using data from the 7th period of the National Health and Nutrition Examination Survey (2016, 2017), 23 sample households were selected using the phylogenetic extraction method among appropriate households and analyzed using the SPSS 18.0 Program. As a result of the study, the unmet medical care of those who had suicidal thoughts compared to those who had not had suicidal thoughts in the past year, when females were higher than males, had worse subjective health status, those who did not subscribe than those who had private insurance, and those who had smoked in the past year. The experience rate was high. This is considered to be able to contribute to improving the medical service system and making policy decisions so that unmet medical care does not occur in the future.