• Title/Summary/Keyword: 보험위원회

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A Study on the Introduction Direction of Private Investigation Law (민간조사업법의 도입방향에 관한 연구)

  • Lee, Seung-Chal
    • Korean Security Journal
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    • no.17
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    • pp.255-276
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    • 2008
  • The important items, which should be considered in Private Investigation Law, can include subjects, licenses, the scope of business, qualifying examinations, and supervisory and penal provisions. The subjects of Private Investigation Law should be permitted to be both natural persons and juridical persons in terms of providing various services, but should be permitted to be juridical persons and should be administered on a license system, even in order to ensure public interests. Concretely, the introduction scope of Private Investigation Law can be regulated to include the followings: that is, investigating the whereabouts identification of runaways and missing children, investigating the personal identification, habit, way of action, motivation, whereabouts identification, real child confirmation, association, transaction, reputation, and personality of specific persons or specific groups, investigating the whereabouts identification of missing persons, owners of government-vested properties or renounced properties, investigating the whereabouts of lost properties or stolen properties, investigating the causes of fire, character defamation, slander, damage, accident, physical disability, infringement on real estate or movable property, and investigating all sorts of accidents including traffic accidents, insurance accidents, and medical malpractices. In the qualifying examination, examinees' age should be restricted to be over age 25. The person, who is exempted from its primary examination, should be restricted to be the person, who has the career of over 20 years in related fields, in consideration of its equity with other certificates of qualification. In the supervisory institution, as the policy institution is the supervisory institution in many countries including France (the police) and Japan (public security committee), so the National Policy Agency should be the supervisory institution in consideration of management aspects. In the penal regulations, especially, we should clarify the management of personal information (personal information protection, personal information management), and so should prevent the infringement of people's basic rights, and then should ensure the public interest.

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Study on the Legal Issues of New Draft of Civil Aviation Law in China (중국 민용항공법 개정 최근 동향과 주요 법적쟁점)

  • Lee, Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.31 no.2
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    • pp.177-214
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    • 2016
  • During more than 20 years of practice, Civil Aviation Law has experienced three times of amendments since it was enacted in 1995. But these revisions are limited to the technical level. The problems and limitations have become increasingly prominent in its implementation. Firstly, the civil aviation law is the result of interests game among several departments and some legal issues was left behind and the regulation was very vague as a result. Secondly, the process of aviation legislation is the process that the country has undergone profound changes and social transformation. The 20 years is long enough for the society to undergo tremendous changes and 1995 version of civil aviation law does not keep pace of development of economy. There was a serious lag between reality and the law. In order to actively promote the development of the aviation industry and overcome implementation issues of the Civil Aviation Law, Civil Aviation Administration of China (CAAC) initiated modification procedure the law and published new draft of Civil Aviation Law in August 2016. The spirit of this modification is to learn and absorb new achievements of domestic and foreign legislation and the International Convention on civil aviation. Furthermore, the purpose of the revision is to provide favorable policy for the development of civil aviation industry and improve aviation safety and supervision, strengthen and protection of consumer rights and interests, to enhance the safety of civil aviation activities, and promote the development of general aviation. This revision concerned to the 78 articles which are revised or deleted and 24 articles added. The highlights of the draft include but not limited to the enhancement of security management, clarification of the main responsibility for production safety. And also it added the provisions related to the construction of effective tracking capability of public air transport enterprises and license system on the transport of dangerous goods. Compared with the existing civil aviation law, the draft has made a great improvements. But there are several deficiencies and limitations in the drafts. These problems need to be supplemented and perfected through further amendments in near future.

Korean Clinical Imaging Guidelines for the Appropriate Use of Chest MRI (한국형 흉부 MRI 영상 진단 정당성 권고안)

  • Jiyoung Song;Bo Da Nam;Soon Ho Yoon;Jin Young Yoo;Yeon Joo Jeong;Chang Dong Yeo;Seong Yong Lim;Sung Yong Lee;Hyun Koo Kim;Byoung Hyuck Kim;Kwang Nam Jin;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.562-574
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    • 2021
  • MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

Demands for Health Education through Internet in Middle and High School Students (중.고등학교 학생들의 인터넷을 이용한 보건교육 요구도)

  • Kang, Pock-Soo;Choi, Yeun-Hwa;Lee, Kyeong-Soo;Hwang, Tae-Yoon
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.23-39
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    • 2004
  • Background: It is important to provide health education to students to ensure a healthy life. Using the internet for health education may be a way to overcome the practical barriers to health education such as time and content. This study was conducted to investigate the demands for health education using the internet. Subjects and methods: Six hundreds and twenty-four and male female students in middle and high schools, who lived on Gyeongju-si and Seongju-gun in Gyeongsangbuk-do province, were interviewed by means of structured questionnaires, from March 5 to March 28, 2003. Results: More than 90% of the subjects had their own computers, and nearly 38% of those possessing their own computers had accessed internet sites related to health and medicine. Middle school students and in particular, female students were more desirous for health education through e-mail. Regarding content, the three major topics which the respondents wanted to learn about were healthy lifestyles, growth and development, and disease prevention. In terms of the interval for providing educational materials, over half of the students wanted information once a week. Most of the students wanted to have the quantity of the material be one page. In addition, there were numerous additional topics requested by the students such as sleep and health, contraception and family planning, safety education, cancer prevention, emotional instability of juveniles, the utilization of medical care facilities, stress management, etc. Conclusion: The students had a desire for health education through the use of e-mail, and methods and materials should be developed for appropriate health education using the internet.

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Impact of a 'Proactive Self-Audit Program of Fraudulent Claims' on Healthcare Providers' Claims Patterns: Intravenous Injections (KK020) (부당청구 예방형 자율점검제가 의료기관의 청구행태에 미치는 영향: 정맥 내 일시주사(KK020)를 중심으로)

  • Hee-Hwa Lee;Young-Joo Won;Kwang-Soo Lee;Ki-Bong Yoo
    • Health Policy and Management
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    • v.34 no.2
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    • pp.163-177
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    • 2024
  • Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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A Study on the Liability for Damage caused by Space Activity - With reference to Relevant Cases - (우주활동에 의하여 발생한 손해배상책임에 관한 연구 - 관련 사례를 중심으로 -)

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
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    • v.26 no.1
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    • pp.177-213
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    • 2011
  • The purpose of this paper is to research on the liability and cases for space damage with reference to the space activity under the international space treaty and national space law of major countries. The United Nations has adopted two treaties relating to the liability for space damage as follows: the Outer Space Treaty of 1967 and the Liability Convention of 1972. Korea has enacted the Outer Space Damage Compensation Act of 2008 relating to the liability for space damages. The Outer Space Treaty of 1967 regulates the international responsibility for national activities in outer space, and the national tort liability for damage by space launching object. The Liability Convention of 1972 regulates the absolute liability by a launching state, the faulty liability by a launching state, the joint and several liability by a launching state, the person claiming for compensation, the claim method for compensation, the claim period of compensation, the claim for compensation and local remedy, the compensation amount for damage by a launching state, and the establishment of the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea regulates the definition of space damage, the relation of the Outer Space Damage Compensation Act and the international treaty, the non-faulty liability for damage by a launching person, the concentration of liability and recourse by a launching person, the exclusion of application of the Product Liability Act, the limit amount of the liability for damage by a launching person, the cover of the liability insurance by a launching person, the measures and assistance by the government in case of occurring the space damage, and the exercise period of the claim right of compensation for damage. There are several cases with reference to the liability for damage caused by space accidents as follows: the Collision between Iridium 33 and Cosmos 2251, the Disintegration of Cosmos 954 over Canadian Territory, the Failure of Satellite Launching by Martin Marietta, and the Malfunctioning of Westar VI Satellite. In the disputes and lawsuits due to such space accidents, the problems relating to the liability for space damage have been settled by the application of absolute(strict) liability principle or faulty liability principle. The Liability Convention of 1972 should be improved as follows: the clear definition in respect of the claimer of compensation for damage, the measure in respect of the enforcement of decision by the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea should be improved as follows: the inclusion of indirect damage into the definition of space damage, the change of the currency unit of the limit amount of liability for damage, the establishment of joint and several liability and recourse right for damage by space joint launching person, and the establishment of the Space Damage Compensation Review Commission. Korea has built the space center at Oinarodo, Goheung Province in June 2009. Korea has launched the first small launch vehicle KSLV-1 at the Naro Space Center in August 2009 and June 2010. In Korea, it will be the possibility to be occurred the problems relating to the international responsibility and the liability for space damage in the course of space activity. Accordingly the Korean government and launching organization should make the legal and systematic policy to cope with such problems.

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Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program (보건지소 공중보건 일반의사의 업무수행정도와 수련개선방안)

  • Park, Jung-Han;Chun, Byung-Yeol;Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.2 s.20
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    • pp.193-202
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    • 1986
  • The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

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Legal Issues on the Collection and Utilization of Infectious Disease Data in the Infectious Disease Crisis (감염병 위기 상황에서 감염병 데이터의 수집 및 활용에 관한 법적 쟁점 -미국 감염병 데이터 수집 및 활용 절차를 참조 사례로 하여-)

  • Kim, Jae Sun
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.29-74
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    • 2022
  • As social disasters occur under the Disaster Management Act, which can damage the people's "life, body, and property" due to the rapid spread and spread of unexpected COVID-19 infectious diseases in 2020, information collected through inspection and reporting of infectious disease pathogens (Article 11), epidemiological investigation (Article 18), epidemiological investigation for vaccination (Article 29), artificial technology, and prevention policy Decision), (3) It was used as an important basis for decision-making in the context of an infectious disease crisis, such as promoting vaccination and understanding the current status of damage. In addition, medical policy decisions using infectious disease data contribute to quarantine policy decisions, information provision, drug development, and research technology development, and interest in the legal scope and limitations of using infectious disease data has increased worldwide. The use of infectious disease data can be classified for the purpose of spreading and blocking infectious diseases, prevention, management, and treatment of infectious diseases, and the use of information will be more widely made in the context of an infectious disease crisis. In particular, as the serious stage of the Disaster Management Act continues, the processing of personal identification information and sensitive information becomes an important issue. Information on "medical records, vaccination drugs, vaccination, underlying diseases, health rankings, long-term care recognition grades, pregnancy, etc." needs to be interpreted. In the case of "prevention, management, and treatment of infectious diseases", it is difficult to clearly define the concept of medical practicesThe types of actions are judged based on "legislative purposes, academic principles, expertise, and social norms," but the balance of legal interests should be based on the need for data use in quarantine policies and urgent judgment in public health crises. Specifically, the speed and degree of transmission of infectious diseases in a crisis, whether the purpose can be achieved without processing sensitive information, whether it unfairly violates the interests of third parties or information subjects, and the effectiveness of introducing quarantine policies through processing sensitive information can be used as major evaluation factors. On the other hand, the collection, provision, and use of infectious disease data for research purposes will be used through pseudonym processing under the Personal Information Protection Act, consent under the Bioethics Act and deliberation by the Institutional Bioethics Committee, and data provision deliberation committee. Therefore, the use of research purposes is recognized as long as procedural validity is secured as it is reviewed by the pseudonym processing and data review committee, the consent of the information subject, and the institutional bioethics review committee. However, the burden on research managers should be reduced by clarifying the pseudonymization or anonymization procedures, the introduction or consent procedures of the comprehensive consent system and the opt-out system should be clearly prepared, and the procedure for re-identifying or securing security that may arise from technological development should be clearly defined.