• Title/Summary/Keyword: Health insurance system

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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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Statistics of Poison Exposure in Korea (국내중독현황)

  • Hwang Jung-Yun;Ko Jae-Ook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.1 no.1
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    • pp.59-64
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    • 2003
  • Objective: This study was conducted for the nationwide statistical survey of poison exposure to provide the rationale for establishing and developing the poison control center (PCC) in Korea. Design: Study group for Korea PCC in National Medical Center reviewed the medical literature on poison exposure of Korea from death reports of National Statistical Office (NSO), the toxic exposure statistics from the report of National Health Insurance Corporation (NHIC), and poison related data from 119 ambulance services (FD) for the purpose of obtaining the poison and its related data. We also conducted questionnaire from the expert who work in emergency medicine department at the designated 320 emergency medical centers in Korea for the preparedness and acknowledgement about necessity of PCC and their need for that. Results: We reviewed the reliable data from the death report of NSO, poison exposure data from NHIC, and running report from FD. Poisoning death occured at home ($36.7\%$) and hospital ($46.3\%$). Poisoning are more common in rural area than the city area. Patients were seen more frequently in the local clinics than in any hospital. The drugs ($45.7\%$) and pesticide ($18.1\%$) are common poison. Common place to poison exposure were residential area ($39.9\%$), industry ($9\%$). mass residential area ($7\%$). and farm ($6\%$). The education level were primary school ($33.2\%$), high school ($23.7\%$), and middle schol ($21.3\%$) in order. We have to provide the poison guideline for lay public to understand easily, and for medical experts. The medical facilities need to be invested and have more interest for toxicology. All medical staff who work in the designated emergency medical center want PCC to establish. They want to have poison information from hospital ($91.3\%$), regional poison information center ($45.0\%$), regional poison control center ($52.5\%$), nationwide poison information center ($48.8\%$), nationwide poison control center ($46.25\%$), as a role of poison control center. They also want that pcc have poison epidemiologic study and statstics, training program for the experts, registration of rare case of posion on website, reflection of policies to activities for antidote production etc., speedy consultation system for poison analysis, public education, establishment of both regional and national pee, etc. Conclusion: Poison center must be established to provide poison information for all the public and medical experitise, focusing rural area and private clinic, to detoxify, to reduce the cost, time, morbity, and mortality through the whole country.

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Start-up Typology and Building Scheme for Housing Related Co-operatives (주거관련 협동조합의 창업유형화 및 조성방안)

  • Kim, Min-Kyun;Oh, Dong-Hoon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.6
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    • pp.79-89
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    • 2014
  • The purpose of this study is to draw the implication for building domestic housing-related co-operatives by understanding activities of housing-related co-operatives from case study and by suggesting the start-up typology for possible domestic housing-related co-operatives and requisites for building them. According to their activities housing-related co-operatives are categorized into three types which are housing supply and operation type, maintain and improve the existing housing type, and design and performance improvement type. National housing policy should be connected to housing co-operatives indirectly. That is, the policy direction ought to be not toward controlling housing co-operatives, letting them supply more houses directly, but toward supporting voluntary co-operatives, showing them the overall housing policy blueprint. Co-operatives cannot be a panacea. Too much protection or support for co-operatives could lead to a reverse discrimination against private companies, and the co-operatives might overuse this kind of prominent position. We need to focus on the possibility of the role of co-operatives as a facilitator for local economy rather than a perfect substitute for the existing economy system.

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A Study of Category Standardization according to Non-benefit Medical Expense in Tertiary Hospitals (상급종합병원 비급여 진료비 변이에 따른 항목 표준화에 관한 연구)

  • Roh, Ock-Hee;Ahn, Sang-Yoon;Kim, Yong-Ha;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.274-280
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    • 2020
  • The purpose of this study was to identify the average cost and present status of non-benefit medical expenses by using the data of tertiary hospitals released by the Health Insurance Review and Assessment Service(HIRA), and to compare the data to find cost variations. The target of analysis was the present status of the non-benefit medical expenses reported by 41 tertiary hospitals among the 44 previously designated hospitals (three were excluded due to revocation or new designation) for 2015, 2016, 2017, and 2018 (until April). This study was conducted after approval of using the released data of the HIRA's data opening system. This study was analyzed by its general characteristics, annual non-benefit medical expenses by frequency analysis, and annual understanding of variation by designating Coefficient of Variation (C.V.). The research found out that the number of details of non-benefit medical expense was gradually increased: the numbers of categories were 51 in 2015, 53 in 2016, and 98 in 2017, but there was a rapid increase in 2018 by 193. As a result, to standardize non-benefit medical expense items across tertiary hospitals due to their variations in the expenses, the government should expand standardized non-benefit medical expenses and make it mandatory for medical institutions to use the standardized items or names of such expenses.

A Study of Trends in Continuing Education Published in the Korean Nurse (간호협회지를 통해 본 보수교육의 역사적 경향 1962년 ~ 1995년)

  • Shin, Sung-Rae;Kim, Kyung-Sun;Lee, Sook
    • The Korean Nurse
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    • v.35 no.2
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    • pp.52-70
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    • 1996
  • This historical research was conducted to analyze and categorize the titles which were presented in the journal, The Korean Nurse, from August 1962 to October 1995. Titles which were published with the purpose of educating graduate nurses and to update 0 their nursing knowledge to improve professional practice were included. There were 348 articles published from the beginning of publication in August, 1962 to October, 1995. All of the journals were reviewed except nine missing journals which were not available in any library. According to the characteristics of the articles in the periodical, the articles were divided into three periods. In each of the three peroids there were five categories: Subject, Clinical Practice, Fundamentals of Nursing Science, Nursing Administration, Others. These categories were adopted from Kim's(1994) division system which was developed to analyze nurse's insurance education program. The special feature peroid was from August, 1962 to December, 1974. In this period the articles were presented in an unorganized manner in the area of special feature or main issue. The largest area was the subject category(44%). The second largest area wes the fundamental of nursing science category(31%). From May, 1975 to December, 1977, the articles with the educational purposes were published in a designated area called continuing education. This period was labelled as the continuing education period. Among the published articles in this period, 45% focused on the subject category and 45% on the fundamentals of nursing science category. In this period the articles were focusing on nurses 'work in specific areas such as industry, nurses' aid schools, and nursing administration, articles on physical assessment first started to appear. The written continuing education period was from January 1978 to October, 1995. All the educational articles published in this area were analyzed and categorized into five areas as for the other periods. 48% of the articles focused on the subject category. In the mid-eighties, the term nurse specialist first.appeared and ten years later in 1990, the titles were subdivided into more specific titles, such as, home nursing, industrial nursing, emergency nursing, 23% were in the fundamental nursing science category and they dealt with nursing process, nursing theories, theory development. For the content analysis, three articles, one from each period, dealing with cardiovscular diseases were selected for comparsion. First, the special feature period, the title of the article was on diet therapy for cardiovascular disease patients, but instead the content was about rest, hygiene, medication, observation. They recommended rings to prevent bed sores, which is now considered as a cause for bed sores. In the continuing education period, the content was more focused on rehabilitation rather than general nursing .care. It became more specific, systematic, and organized compared with the special feature period. In the written continuing education period, the focus was on rehabilitation, not broadly, but very specifically on exercise. The further research on the content analysis is recommended along with a comparison of the trends in the Journal of Nurses Academic Society.

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A Comparative Study on Total Payment of Mental and Behavioral Disorders Patients Admitted through the Emergency Room: Focusing on Main & Sub Sick (응급실 경유 정신 및 행동장애 입원환자들의 총진료비 비교 : 주상병과 부상병 환자 중심으로)

  • Choi, Hyun-Sik;Lee, Hyun-Sook
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.562-569
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    • 2014
  • The purpose of this study was to investigate the determinants of total payment for mental and behavioral disorders patients admitted through the emergency room. Study data was selected from the Korean National Health Insurance sample data in 2009. This data was consisted of 753 inpatients who are 331 inpatients with only main sick(F31-F39) and 422 inpatients with main sick codes(F31-F39) and sub sick(F00-F99) admitted through the emergency room. SPSS v.18 was used for the statistical analysis such as descriptive analysis, t-test, ANOVA, and multiple regression analysis. In multiple regression analysis, significant variables affecting total payment of main sick patients were gender(p<.01), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). Also, main sick patients with sub sick were gender(p<.01), age(p<.001), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). These findings implied that it is necessary to build short, middle, and longterm program and system for high risk mental and behavioral disorders groups.

Impervious Surface as a Thematic Parameter of Analysis for Childhood Asthma Hospitalizations : Spatio-temporal Approaches (소아천식 유병율 분포의 분석변수로서 불투수면 : 시공간적 접근)

  • Um, Jung-Sup
    • Journal of the Korean association of regional geographers
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    • v.16 no.6
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    • pp.706-723
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    • 2010
  • The impervious surface was frequently employed as a proxy of the total environmental burden in the urban area. The impervious surface was extracted from a satellite image and the GIS (Geographical Information System) database for childhood asthma hospitalizations was generated for a total of 62,136 children using the National Health Insurance database of South Korea. Children living in an impervious environment do result in almost twice as many hospitalizations (26.58%) for asthma, as compared to the sub-urban pervious living (15.82%). Furthermore, the risk zones with persistently high hospitalizations for three years were specifically identified over the impervious sub-district alone. The impervious zone showed a small inter-year variation of hospitalizations (r: 0.937) while the sub-urban pervious fringe was found to display a yearly variation(r: 0.371). The strong temporal autocorrelation means that the impervious areas have frequent long-lived hospitalizations for asthma, thus children living in impervious areas were likely to have had more chronic asthma attacks than those living in pervious areas. These experimental results indicate that an impervious surface as thematic parameter of analysis is a crucial explanatory variable for asthma hospitalizations and its longer persistence among children.

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Epidemiology Study of Patients with Neuropathic Pain in Korea (한국의 신경병성 동통 환자에 대한 역학조사)

  • Won, Jung-Yeon;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.353-374
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    • 2008
  • The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

Convergence Research on Periodic Changes in the Quality Assessment of Surgical Prophylactic Antibiotics (수술 예방항생제 적정성 평가의 주기별 융합 변화 연구)

  • Yang, Sae-Yie;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.325-333
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    • 2016
  • This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

A Comparative Study of Knowledge, Attitude, and Experience towards Dental Tourism between Indonesian and Korean People (한국과 인도네시아의 치과 의료관광에 대한 지식, 태도, 경험의 비교)

  • Deasy, Rosalina;Kim, Jong-Yeon;Hong, Seong-Ae
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.299-308
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    • 2014
  • Nowadays, dental tourism becomes phenomenon because of its cost-effectiveness, improvement of quality and technology, dental infrastructure, and attractive tourism. Korea as one of popular destination country had established dental system. On the other hand, Indonesia with high number of population is potential market for dental tourism. The aim of this study is to compare the knowledge, attitude, and experience towards dental tourism among Indonesian and Korean. Two cross-sectional descriptive surveys were conducted to collect the data. This study was used one questionnaire in two different languages due to nature of the study population. Data from a total 923 of Indonesian from 33 provinces in Indonesia was collected during the period from April through July 2010. On the other hand, during May until August 2010 data from a total of 312 Korean were obtained. It was found that the majority of participants in both countries had never heard about dental tourism. Among those who had heard about dental tourism, the most common source was internet. Ownership of dental insurance had significant relationship with knowledge of dental tourism among Indonesian while level of education and monthly internet usage had it among Korean (p<0.05). Attitudes of Indonesian and Korean people about dental tourism were negative due to assumption that dental services in their home country were satisfactory. 100% of Korean had no experience on dental treatment in other countries while 2.4% of Indonesian had experience with it. In conclusion, regarding all these evidences, comprehensive and positive information about dental tourism is needed to enhance people's knowledge, attitude, and experience.