• Title/Summary/Keyword: Health insurance act

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THE STUDY ON THE DEVELOPMENT OF RELATIVE VALUE IN MEDICAL TREATMENT OF THE ORAL AND MAXILLOFACIAL SURGERY (구강악안면외과 의료행위 상대가치 개발에 대한 조사연구)

  • Song, Gin-Ah;Baek, Kyung-Won;Hwang, Jong-Min;Yu, Soon-Yong;Choi, Jin-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.4
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    • pp.334-347
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    • 2006
  • The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.

The Present Situation, Problems, Improving Plans about the Establishment and the Operation of a Medical Association - Mainly on the Violations of the Rules Regulating Medical Institute's Opening - (의료협동조합의 의료기관 개설·운영 현황과 문제점 및 개선방안 - 의료기관 개설기준 위반을 중심으로 -)

  • KIM, JOON RAE;BAEK, NAM BOK;LEE, YOON HAK
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.227-261
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    • 2015
  • Cooperative associations are established in order to enhance the rights and the interests of their members and serve the local communities, and actually do much for the local society. And among these, consumer cooperatives are spontaneously founded, particularly in the spirit of mutual help, in order to promote the common welfare of the members. Meanwhile, because the current medical law qualifys noncommercial corporation to open medical institution, consumer cooperative and noncommercial- corporation cooperative which are established under the Cooperative Act have the right to do. However, though cooperative association should be founded for common interests of the members who are weaker parties of society, it became rapidly to be abused as means of circumvention of law. Especially as National Health Insurance Corporation stepped up the investigation and the collection of unfair profits against the hospital owned by non-medical personnel who are unable to establish a medical institution, setting up medical institutions as a roundabout way to avoid the restricts dramatically increased in number. In this study, we are going to introduce the current dualised normative system regulating the establishment of a medical cooperative association, and find a way to improve the system and make up for the week points. And we will look though the present situation about medical cooperative association's opening, operating, and closing, and review the normative and systematic improving plans.

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Job Analysis of the Nurses Who Work in Customized Visiting Health Care Services using DACUM Technique (맞춤형 방문건강관리사업 내 방문간호사의 직무분석)

  • Nam, Hye Kyung;Cho, Kyung Sook
    • Journal of muscle and joint health
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    • v.22 no.3
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    • pp.205-218
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    • 2015
  • Purpose: This study was performed to analyze the visiting nurses' job using Developing a curriculum (DACUM). Methods: The DACUM committee with 6 visiting nurses participated in the workshop. In this workshop, the visiting nurses role was defined and their duties and tasks were identified. After content validation via the experts, the pilot test was conducted to 78 nurses. Results: A total of 13 duties and 82 tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks with alphabet A, B, and C as its higher degree. Regarding duties, 'visiting nursing for high risk group' is the highest, while the lowest was 'public welfare events'. Regarding to tasks, 'discovering a new patient' was the highest, while 'selecting patients and offering medical supplies (nutritional supplement, patch)' was the lowest one. Conclusion: The results showed that visiting nurses working in the visiting health care service center were doing more various duties and tasks than those working according to 'Act on Long-term Care Insurance for the Aged'. The results can be used to develop training programs for visiting nurses and evaluation-scale of their job performance.

Research on a Valuation Standard and the Actual Condition About Security Management in PACS (PACS에서 보안관리 평가기준 연구와 실태조사)

  • Jeong, Jae-Ho;Dong, Kyung-Rae;Kweon, Dae-Cheol;Son, Gi-Gyeong;Kim, Hyun-Soo;Kang, Hee-Doo
    • Journal of radiological science and technology
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    • v.31 no.4
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    • pp.347-353
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    • 2008
  • This study is to prepare an evaluation standard about personal information protection and security management of a medical institution and to build up a grade standard of evaluation in PACS environment. We built up evaluation index based on 10 detailed items in four big categories (political security, technical security, data management security and physical security) by referring to ISO17799 (BS 7799), HIPPA (Health Insurance and Portability and Accountability Act of 1996) and domestic medical law. We have investigated at the thirty places where medical facility with the extracted security criteria and security evaluation index. Average score of physical security list, one of the big categories, was 18.5/20 (93%) at all medical institutions. Political security score was 18.5/30 (62%), data management security score was 12/20 (60%) and technical security score was 17.5/30 (58%). Therefore, security evaluation score was average 67 in 30 general hospitals, which was 4th level. The results showed that it is necessary to establish evaluation and management standard about personal information protection and security consciousness which are weak in PACS environment.

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OCTAVE Allegro 위험 평가 방법론 연구 및 소개

  • Park, Jun-Yong;Lim, Dae-Woon
    • Review of KIISC
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    • v.21 no.6
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    • pp.67-72
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    • 2011
  • 카네기멜론 대학의 SEI(Software Engineering Institute)는 개인 의료 정보의 보안을 규정한 HIPP A(Health Insurance Portability and Accountability Act)의 조항을 미 국방부(DoD)가 제청하면서 직면하게 된 보안 준수의 난항을 해결하기 위해서 TATRC(Telemedicine and Advanced Technology Research Center)와 공동으로 자산 식별 및 정보보호 위험평가를 위한 방법론인 OCTAVE를 개발하였다. 이후 조직의 운영 과정에서 발생하는 위험의 내성을 높이기 위한 질적 위험평가 기준이 개발되었으며 이를 통해 조직의 중요한 자산 및 잠재적 위협과 취약점을 식별하는 위험평가 방법으로 발전하였고, 2005년에는 100명이하의 소규모 조직에 적합한 OCTAVE-S가 발표되었다. 오늘날 급변하고 있는 IT 환경에서 기존의 OCTAVE 보다 간소화되고 최적화된 위험평가 프로세스를 제공하기 위해서 2007년에 OCTAVE Allegro 프레임워크가 개발되었다. 본고에서는 기존의 OCTAVE 방법론의 주요 특정을 살펴보고, 정보자산 중심의 OCTAVE Allegro 위험 평가 방법론을 소개한다.

Improvement Devices on the Law and Institution and Current Situation of Health and Medical Treatment for the Aged (노인보건의료의 현황과 법 제도적 개선방안)

  • Noh, Jae-Chul;Ko, Zoon-Ki
    • The Journal of the Korea Contents Association
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    • v.13 no.4
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    • pp.170-186
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    • 2013
  • As the population is getting older, medical expenses amount of the whole is keep increasing. So, the pressure of the finances, Health Insurance, Medical Care Assistance Act and etc, is getting higher. The share of healthcare-expense is increasing due to elderly illness. And it became a social problem; we analysed present state of senior healthcare in South Korea-looked into current laws and policies, and found problems. We tried to suggest improvements that drew from the current state of foreign country senior healthcare of those problems. For the result, we found the problem in relevant-law system of senior healthcare guarantee. In this study, we proposed the ways to qualitatively upgrade of medical standard that considered on elderly' features: the strengthened guarantee for healthcare, financial secure for long-term convalescence benefit, linking and functional reinforcement for elderly welfare and long-term convalescence insurance, the solution for overlapped laws about convalescence in long-term convalescence insurance and elderly welfare, a betterment of grading, and a home service consolidation. We need to secure right amount of emergency medical service budget, and effective management system for the improved level of senior severely emergency medical service. Furthermore, we suggested that South Korea needs to legislate [The Law for Senior Medical Secure] to respond to rapidly increasing senior healthcare fee.

A Study on Attitudes on Health Institution and their Utilization (일부(一部) 주민(住民)의 의료기관(醫療機關)에의 태도(態度) 및 의료이용(醫療利用)에 대(對)한 연구(硏究))

  • Choi, Young-Joo;Cha, Hyung-Hun;Yum, Yong-Tae
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.35-43
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    • 1983
  • Health institutions in Korea include a wide range of traditions, most notable of which are hospitals, clinics, pharmacies and health centers as foci for the dispension of western medicine care ; and herb clinics and shamans acting as centers for traditional medicine. Health consumers have pluralistic conceptions of illness(or disease) and act accordingly, using what they consider as appropriate medical practices. The research conducted surveyed residents of Jeomdong-Myon(a rural farming district), Guro 6-Dong(an urban district) and the Banwol(a semiurban district) area on attitudes about health institutions and their utilization of them. The results indicate that the hospital is considered the most reliable health institution, however, the most widely known and commonly used institution was the pharmacy. Hospitals and clinics were found to be utilized more frequently by those residents who were familiar with them than by others less familiar with them. In addition respondents with higher education, those with medical insurance, and those living in urban areas tended to utilize hospitals and clinics more frequently than their less educated, uninsured, or rural counterparts. Converse to the ranking of western medical institutions, traditional health institutions were rated low with regards to reliability, familiarity and utilization. This indicates that western medical care has pervaded the Korean medical system.

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Anwendungsbereich der Verleitung des Patienten im Sinne des ${\S}27$ Abs. 3 das Gesuntheitsdienstgesetz (의료법 제27조 제3항 환자 '유인' 금지의 적용범위)

  • Lee, Seok-Bae
    • 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.

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Cohort Study Protocol: A Cohort of Korean Atomic Bomb Survivors and Their Offspring

  • Seong-geun Moon;Ansun Jeong;Yunji Han;Jin-Wu Nam;Mi Kyung Kim;Inah Kim;Yu-Mi Kim;Boyoung Park
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.1
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    • pp.1-11
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    • 2023
  • In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea's Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.

A Normative Review on Non-Invasive Prenatal Diagnosis (NIPD): Focusing on the German Discussion on PrenaTest®

  • Kim, Na-Kyoung
    • Development and Reproduction
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    • v.25 no.2
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    • pp.113-121
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    • 2021
  • This article aims to introduce German discussion on the approval of the non-invasive prenatal diagnosis (NIPD), which started with the development of PrenaTest® by LifeCodexx AG. The discussion started with the concern that the non-invasive nature of NIPD, such as PrenaTest®, may rapidly expand the use and scope of similar tests, thus leading to a new era of eugenics. Based on this concern, the need for clear clinical guidelines on specific indications for NIPD has been suggested. Along the same line, it was discussed whether PrenaTest® is against the Basic Law prohibiting discrimination on grounds of disability and whether the test is outside the scope of the purpose of gene testing limited by Genetic Diagnosis Act. Through such discussion, the Federal Ministry of Health of Germany established the preconditions for inclusion of NIPD in the German public health insurance system. For this, the German motherhood guideline was amended and the information for the insured persons provided to pregnant women was included in the amended guideline. Such discussion made in Germany provides insight on which points should be considered when various gene testings are accepted in Korea, in which genetic communication has not been systematized yet. In particular, German counseling system for pregnant women will provide valuable insights for Korea where the direction for regulations on abortion has not been established even after the ruling by the Constitutional Court that charges for abortion are against the constitution.