• 한국임상약학회지
• /
• 제30권3호
• /
• pp.177-184
• /
• 2020

Background & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion: This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

• 보건행정학회지
• /
• 제31권4호
• /
• pp.387-398
• /
• 2021

Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

• 무역상무연구
• /
• 제2권
• /
• pp.7-44
• /
• 1991

• 무역상무연구
• /
• 제8권
• /
• pp.121-149
• /
• 1995

• Restorative Dentistry and Endodontics
• /
• 제17권2호
• /
• pp.431-438
• /
• 1992

• 의료법학
• /
• 제20권3호
• /
• pp.3-45
• /
• 2019

건강보험은 국민의 건강을 보장하는 헌법적 과제를 실현하는 주축 수단이다. 건강보험의 과제를 살펴보기 위해서는 역사적으로 형성된 우리 건강보험의 특성, 건강보험 자체의 급여와 관련된 특성 및 규범적 특성을 이해하여야 한다. 우리 건강보험은 낮은 수준의 보편적 평등을 지향하였다. 이는 역설적으로 건강보험을 보편화하는 데 유리한 상황이 되었다. 건강보험의 과제는 포괄적이며, 적극적·개방적이다. 그러나 건강보험은 평균적 진료와 재정안정성을 유지하기 위하여 어느 정도 정형화된 진료의 종류와 내용 및 방법을 규범화하여야 한다. 건강보험은 한편으로는 이를 벗어나는 진료를 통제하여야 하지만, 다른 한편 진료의 필요성과 효과성을 기준으로 이를 보충하여야 한다. 그런데 이러한 두 요청은 일치할 수 없다는 구조적인 한계가 있다. 이 글은 위와 같은 건강보험의 특성을 기준으로 건강보험의 역사를 정리하고, 앞으로 남겨진 과제를 분석하고 개선과제를 제시하는 목적을 갖는다. 건강보험이 처한 새로운 상황에서 건강보험의 보장성을 부분적으로 강화하는 문제, 건강보험의 제도 및 재정위기의 구조적 문제, 건강보험에 특유한 거버넌스와 관련된 현재의 문제 및 개선방향을 제시하였다.

• 한국실천공학교육학회논문지
• /
• 제4권2호
• /
• pp.144-149
• /
• 2012

본 논문은 고용보험 사각지대의 실태를 분석하고, 사각지대 해소를 위한 여러 정책 대안을 비교분석하여 합리적인 대안을 모색하고 있다. 고용보험 사각지대 해소를 위한 대안으로서 고용보험 미가입자의 가입 활성화 방안, 적용 제외 근로자의 적용 확대 방안, 실업급여의 관대화 방안, 비임금근로자의 고용보험 적용 방안, 실업부조 및 실업보험저축계좌제 도입 방안, 맞춤형 패키지 사업을 활성화 방안을 검토하였다. 전문가에 의한 설문조사와 객관적 평가 기준에 의한 평가 결과 각각의 대안은 나름대로의 장단점이 있지만 고용과 복지가 연계된 맞춤형 패키지 사업을 활성화하는 것이 바람직한 것으로 나타났다. 따라서 1차적으로는 고용보험 미가입자에 대하여 가입률을 높이고, 법령상의 적용 제외 근로자를 최소화하면서, 고용보험으로 보호하기 어려운 비임금근로자와 실업급여 수급자격이 없는 구직자 등에 대해서는 심층상담, 직업훈련, 집중적인 취업알선 등 맞춤형 패키지 사업을 활성화하는 것이 바람직하다.

• 보건행정학회지
• /
• 제29권2호
• /
• pp.184-194
• /
• 2019

Background: The extent of coverage rate of the public health insurance is still insufficient to meet healthcare needs. Private health insurance (PHI) plays a role to supplement coverage level of national health insurance in Korea. It is expected that reduce unmet need healthcare. This study was aimed to identify relationship between PHI type and the unmet healthcare need and its associated factors. Methods: Data were obtained from the 2014 Korea Health Panel Survey using nationally representative sample was analyzed. Respondents were 8,667 who were adults over 20 years covered by PHI but have not changed their contract. According to the enrollment form, PHI was classified into three types: fixed-benefit, indemnity, and mixed-type. To identify factors associated with unmet needs, multiple logistic regression conducted using the Andersen model factors, which are predisposing factors, enabling factors, and need factors. Results: Our analysis found that subjects who had PHI with mixed-type were less likely to experience unmet health care needs compared than those who did not have it (odds ratio, 0.80; 95% confidence interval, 0.66-0.98). As a result of analyzing what affected their unmet healthcare needs, the significant factors associated with unmet medical need were gender, marital status, residence in a metropolitan area, low household income, economic activity participation, self-employed insured, physically disabled, low subjective health status, and health-risk factors such as current smoking and drinking. Conclusion: The results of this study suggest that having PHI may reduce experience of unmet healthcare needs. Findings unmet healthcare needs factors according to various subjects may be useful in consideration of setting policies for improving accessibility to healthcare in Korea.

• 한국직업건강간호학회지
• /
• 제28권4호
• /
• pp.208-220
• /
• 2019

Purpose: This study aimed to determine health problems experienced by workers in special employment relationships (WSER) and identify coping strategies used when such problems occur. Methods: This qualitative study used the focus group interview method. Thirteen study participants included five home-visit tutors, five insurance salespersons, and three credit card recruiters. The interviews were conducted from November 2018 through January 2019, with each occupational group interview lasting about 2 hours. Analysis based on phenomenological research was independently performed by two researchers. Results: Most participants had common health problems involving vocal cord symptoms, and stress related to emotional labor and traffic accidents. The unique health problems included cystitis, musculoskeletal, and digestive symptoms in home-visit tutors; reduced vision and hearing in insurance salespersons; and mental distress in credit card recruiters. There was no protection system for their health coverage, and the company emphasized their self-employed status to avoid taking responsibility for them. Twelve participants did not purchase occupational accident insurance owing to both not having adequate information and economic burden concerning premium status. Conclusion: WSER experienced both physical and mental health problems. These problems were caused by their unstable employment status, and the social security system for their coverage being non-functioning.

• 한국의료질향상학회지
• /
• 제28권1호
• /
• pp.2-13
• /
• 2022

Purpose: This study assessed the status of the Development and Utilization of critical pathways (CP) in South Korea. Methods: We surveyed 195 hospitals obtained on the Korean Hospital Association website. Data were collected using structured questionnaires for staff members in charge of CP management personnel in these hospitals. The questionnaire included CP developed by the institutions, the coverage rates and completion rates of CP in the current year, and management indicators related to CP. The questionnaire also included CP support systems and content within the institutions and questions regarding the advantages of CP utilization and obstacles associated with the CP development process. Results: Analysis of the responses from 70 hospitals (35.9% response rate) showed that a total of 1,370 CP sets were developed. The number of CP related to surgery departments was 365 (26.6%), and CP related to surgery and procedure was 1,093 (79.8%), respectively. The CP coverage rate was the most frequently used indicator to monitor the effect of CP (97.1%), followed by the completion rate (90.0%) and the length of stay in hospital (61.4%). CP managers reported that CP were highly useful for communication (3.39±0.493) and accurate information provision (3.39±0.491). The perception that CP violated doctors' autonomy in treatment was relatively low (2.87±0.645). Conclusion: It is necessary to establish an infrastructure in hospitals for CP. CP can facilitate communication and provide accurate information.