• Title/Summary/Keyword: 의료계약

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Rechtliche Probleme $\ddot{u}$ber die Patienten im Arztvertarg (의료계약의 당사자로서의 "환자"와 관련한 문제에 대한 검토)

  • Kim, Min-Joong
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.253-286
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    • 2009
  • Die $\ddot{a}$mrztliche Behandlung des Patienten durch den Arzt geschieht im Rahmen eines Rechtsverh$\ddot{a}$ltnisses. Das Arzt-Patienten-Rechtsverh$\ddot{a}$ltnis stellt regelm$\ddot{a}$ssig der Arztvertrag oder Behandlungsvertrag dar. Arzt und Patient schliessen einen Arztvertrag ab. Grunds$\ddot{a}$tzlich verbindet der Arztvertrag die Partner pers$\ddot{o}$nlich. Aber minderj$\ddot{a}$hrige Patienten sind gesch$\ddot{a}$ftsunf$\ddot{a}$hig oder in der Gesch$\ddot{a}$ftsf$\ddot{a}$higkeit beschr$\ddot{a}$nkt. Minderj$\ddot{a}$hrige Patienten verm$\ddot{o}$gen also allein grunds$\ddot{a}$tzlich keine wirksamen Willenserkl$\ddot{a}$rungen abzugeben und somit keine wirksamen Arztvertr$\ddot{a}$ge zu schliessen. Arztvertr$\ddot{a}$ge von minderj$\ddot{a}$hrigen Patienten sind nur bei Einwilligung der gesetzlichen Vertreter wirksam. Vom Abschluss des Arztvertrags ist deutlich die Einwilligung zur Behandlung zu unterscheiden. Die Einwilligung ist kein Rechtsgesch$\ddot{a}$ft. Die Einwilligung durch die Eltern erfolgt nur solange der minderj$\ddot{a}$hrige Patient nicht reif genug ist, die Entscheidung selbst zu treffen. Jugendlicher Patient ist z.B. in der Lage, die Einwilligung selbst zu geben, sofern er Wesen, Bedeutung und Tragweite der Behandlung zu verstehen vermag. Der Vorschriften des KBGB zur Gesch$\ddot{a}$ftsf$\ddot{u}$hrung ohne Auftrag gelten, wenn der Arzt einen Bewusstlosen versorgt. Nach $\S$734 KBGB erfolgt die Gesch$\ddot{a}$ftsf$\ddot{u}$hrung ohne Auftrag dann zu Recht, wenn sie dem Interesse und dem wirklichen oder mutmasslichen Willen des Patienten entspricht. Der Patient kann aus einem Ausland stammen. F$\ddot{u}$r ausl$\ddot{a}$ndische Patienten gilt generell das koreanische Recht. Grunds$\ddot{a}$tzlich sollte man einen des Koreanischen nicht m$\ddot{a}$chtigen Ausl$\ddot{a}$nder nach M$\ddot{o}$glichkeit in seiner Sprache aufkl$\ddot{a}$ren und dann den Arztvertrag abschliessen. Aufgrund der Privatautonomie kann jeder Patient frei entscheiden, ob, mit wem und wor$\ddot{u}$ber er einen Arztvertrag abschliesst. Deswegen ist auch der Wille des Anh$\ddot{a}$ngers vom Sekten und abweichenden Lebensauffassung grunds$\ddot{a}$tzlich zu ber$\ddot{u}$cksichtigen. Zum Beispiel handelt der Zeuge Jehovas auf eigene Gefahr, wenn er eine notwendige Behandlung ablehnt. Aber die Freiheit, eine gebotene Behandlung abzulehnen, kann in Konflikt mit dem Schutz des minderj$\ddot{a}$hrigen Patienten gelangen. Sobald die sektiererische oder abweichende Haltung droht, einen minderj$\ddot{a}$hrigen Patienten zu gef$\ddot{a}$hrden, hat das elterliche Sorgerecht einzuschr$\ddot{a}$nken.

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Critical Overview on Changes of Judicial Precedents in the Medical Cases of Korea - In Relation with Forms of Judgments and Damages - (우리나라 의료판례 변화에 대한 비판적 고찰 - 판결양식과 손해배상액을 중심으로 -)

  • Shin, Hyun Ho
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.83-122
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    • 2014
  • Compared with medical cases and health care law from other countries there has been a lot of progress on medical law, especially on medical precedents in Korea. However, in recent years, medical precedents tend to reflect a realistic position of health care providers, rather than normative position of the victim. The burden of proof to prove strict liability is given to patients in civil law suits by courts, patients generally has the burden of proof. The rate of claims to prove the negligence of medical malpractice is falling significantly. Even if the error is acknowledged, it is not enough to get right to be relief for patients by increasing limitations of liability or ratio of patient's own negligence. Compensation fee is included in medical fees and risk of medical malpractice actions contributes ultimately to a health care consumer. In conclusion, author represents a major the new upgrade of above mentioned problem. By advising that court should assess actively for the perspective of victim for medical negligence we will be able to exercise remedies of patients' rights and to prevent recurring medical accidents and also contribute to medical advances.

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Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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A Modeling of an efficiency analysis based on DEA_AR and AHP for the improvement of usefulness of the Accreditation of Hospitals (의료기관평가의 유용성 증대를 위한 AHP와 DEA_AR 기반의 효율성 분석 모델 구축)

  • O, Dong-Il
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.7
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    • pp.2406-2419
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    • 2010
  • This study aims to elevate the usefulness of the current annual Accreditation of Hospitals. To achieve this purpose, A modeling of an efficiency analysis based on DEA and AHP to the Accreditation of Hospitals Data from 2004 to 2008. By applying to AHP and DEA_AR to the scores derived from the various domains in data, An adequate prediction model about conversion factor in fee contract is made. By summarizing information derived from DEA, factor analysis and Generalized Linear Model, The linear functions combining conversion factor and efficiency index is successfully established. The factor analysis with AHP was used to merge diverse scores from the domains of evaluation. Not only the input and output initially introduced, AHP scores, dummy variables of hospital classification, geographical location are effective variables to forecast a conversion factor. If a predicted conversion factors from efficiency is used, It will be a great contributions to the annul doctor's fee contract.

The Success requirement of implementing Medicare's SGR in Korea (Medicare의 SGR을 우리나라에 도입하기 위한 전제)

  • 오동일
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.3 no.3
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    • pp.221-226
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    • 2002
  • The SGR system which is the basis for setting Medicare conversion factor updates was enacted since 1992. The SGR sets a target rate of spending growth based on factors influencing medical costs. In our situation of Fee Contracts in Korea, there exist much conflicts with SGR. This article seeks how we can implement the SGR system successfully in Korea. The major points are estimation of real economic parameters, adjustment of prior estimation, consideration of important factors influencing medical costs.

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Design of Lab Management Service Platform for Providing Test Request and Result (검사의뢰 및 검사소견 제공을 위한 검사관리 서비스 플랫폼 설계)

  • Kim, jae-su;Kim, jae-woong;Park, koo-rack
    • Proceedings of the Korea Contents Association Conference
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    • 2016.05a
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    • pp.9-10
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    • 2016
  • 본 논문에서는 의료기관에서 수진자의 검사정보를 검사기관과 1:1 계약이 아닌 다양한 검사기관으로 위탁 의뢰 할 수 있고, 검사의뢰나 검사결과 보고만을 하는 기존 검사관리 시스템과는 달리 검사결과 정보를 바탕으로 한 다양한 부가서비스를 제공할 수 있는 통합 검사관리 서비스 플랫폼을 제안한다. 본 논문에서 제안하는 서비스 플랫폼은 다양한 의료기관과 검사기관을 하나의 통합 검사관리 시스템에 연결, 병 의원 업무의 효율성 및 서비스 질 향상을 지원한다.

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A Contractual Study on the Clinical Trial of Medicine (의약품 임상시험의 계약적 일고찰)

  • Song, Young-Min
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.257-285
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    • 2011
  • This thesis has studied about the legal characteristic of injection of the trial drug, the position of the pharmaceutical firm as a contractor of the clinical trial, the possibility of compulsory performance of consistent injection of the trial drug, and the damage claim caused in the process of the clinical trial from the viewpoint of protecting the trial subject in the clinical trial. According to court's judgement in the United States, the lawsuit of the trial subject, although the trial subject had expected consistent injections, was dismissed because there was no direct contract between pharmaceutical and trial subject. However, Helsinki Declaration prescribe the medical research as follows. 'All patients who participated in the research should be able to use the best precaution, diagnosis, and treatment proved by the final outcome of the research'. The trial subject is entitled to demand only the pharmaceutical firm which developed and provided the trial drug, and the pharmaceutical firm has the obligation to supply the trial drug to the trial subject. Therefore, it would be not enough to protect the trial subject if the pharmaceutical firm which makes the trial drug is ruled out. In addition, especially, in case the trial drug has a constant effect with the aim of treatment, if the injection of the trial drug is suddenly stopped, the trial subject would not have the benefit of treatment by the trial drug. In this case, the best remedy against the damage is to urge a constant injection of the trial drug. Thus, in certain case, it is reasonable to consider that the pharmaceutical firm has the obligation to supply the trial drug to the trial subject constantly, and it is also necessary to compel it through effective means in case the pharmaceutical firm do not fulfill its obligation to supply the trial drug. However, as an essential prerequisite for the assertion mentioned above, it should be judged under the principle of good faith considering the concrete situation, that is, what roles the pharmaceutical firm has played.

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A Study on the Request for Proposal & Outsourcing of Management for PACS in Kyung Hee Medical Center (경희의료원 PACS 운영관리를 위한 외주관리와 제안요청 연구)

  • Kang, H.D.;Jung, J.H.;Son, G.G.;Seong, D.U.
    • Korean Journal of Digital Imaging in Medicine
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    • v.9 no.1
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    • pp.45-51
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    • 2007
  • PACS 유지보수 서비스의 중요성을 살펴보고 PACS 분분별 제안요청 요소를 분석하여 향후 시스템 유지보수 계약의 지표를 제공하는데 목적이 있으며 경희의료원의 PACS 유지보수 제안서요청의 사례를 중심으로 유지보수 RFP 작성의 필요성, 중요사항 및 분야별 요구사항 등에 대하여 기술한다. 제안 부문은 9 개로 구분하였으며 총 139 항목의 제안 요청 사항을 정리하였다. 제안 요소 연구의 결과는 다음과 같다. 1. PACS 유지보수 분야는 PACS Software 부문, 데이터베이스 부문, 서버 및 스토리지 부문, 네트워크 부문, CR 및 DR System 등과 같은 영상획득장치에 관한 부문, 판독용 및 임상용 모니터 부문 등으로 구분하며, 각 부문별 제안 요구사항을 기술한 제안요청서를 작성하여 각 부문별 제안서를 요청하여야 한다. 2. 병원에서는 PACS 부문의 외주관리를 체계적으로 구분 관리하여 시스템 유지보수의 수준을 높이고 이를 질 높은 의료서비스로 연계되도록 하여야 한다. 3. PACS 관련 회사는 병원에서 요청된 제안 요청사항을 수용하며 질 높은 관련부문 서비스를 제공하기위한 기술적 배경을 체계화하여야하며 향후 주요 매출원으로 자리 잡게 될 유지보수 서비스를 상품으로 인식하고 이에 대한 적극적인 상품화전략과 홍보 노력이 필요하다.

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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
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    • v.21 no.1
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    • pp.69-105
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    • 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.