• 대한의용생체공학회:의공학회지
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• 제44권4호
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• pp.264-274
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• 2023

Purpose: The objective is to extract insights that can contribute to the formulation of harmonized international policies and support measures for innovative medical devices and management systems. This study aims to propose effective strategies for future medical device innovation and healthcare delivery. Results: It investigates technological advancements, regulatory approval systems, insurance policies, and successful commercialization cases in South Korea, the United States, and the European Union. In 2018, the FDA implemented insurance coverage for Software as a Medical Device (SaMD) and recognized insurance coverage for Digital Therapeutics (DTx). Germany is a country that ensures permanent reimbursement for healthcare applications since 2020, making it the first country to provide legal health insurance coverage for fostering a digital ecosystem. Conclusion: The findings of this research highlight the importance of cultivating a supportive regulatory and environmental framework to facilitate the adoption of innovative medical devices. Continuous support for research and development (R&D) efforts by companies, along with the validation of clinical effectiveness, is crucial.

• 융합정보논문지
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• 제11권10호
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• pp.194-204
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• 2021

본 연구는 생애주기별 민간의료보험 가입 현황 및 가입 요인을 알아보고, 민간의료보험 가입에 따라 생애주기별 의료이용 행태 차이를 파악하고자 시행하였다. 한국복지패널 12차-15차(2016-2019년) 자료를 SPSS 26 프로그램을 사용하여 58,223명의 인구사회학적 및 건강 특성에 따른 민간의료보험의 가입 현황 차이는 Chi-square, 가입 영향 요인은 다항 로지스틱 분석, 의료이용 행태는 평균분석하였다. 분석결과 민간의료보험의 가장 큰 가입요인은 가구소득이었으며, 성장기의 민간의료보험 가입이 생애주기 중 가장 높았고, 가구소득에 의해 복수 가입되었다. 청장년기는 가구소득과 유배우자, 장애가 없는 경우, 중년기는 가구소득과 경제활동, 유배우자, 건강수준이 큰 영향요인으로 나타났다. 노년기의 민간의료보험 가입률이 가장 낮았고, 저소득가구, 낮은 건강수준, 장애가 있는 경우에서 낮았다. 민간의료보험 가입자들의 의료이용 증가도 성장기와 청장년기에 나타났다. 국민건강보험의 보장성 강화와 이를 보충하기 위한 민간의료보험의 역할을 생애주기에 맞춰 정립하여 상호보완적으로 작용하게 하여 의료보장의 사각지대를 없애고, 국민의 건강과 후생을 최대화하여야 할 것이다.

• 대한한방부인과학회지
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• 제20권1호
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• pp.239-257
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• 2007

Purpose : In the part of Ob & Gy disease, the health insurance application is very limited. This study has been performed for gaining the basic data of enlargement of insurance coverage and reform of the insurance system corresponded with real clinical conditions. Methods : The survey has been practiced twice, the subjective questionnaire was used at the first survey. Then the questionnaire written using the results of first survey was distributed to the Korean medical doctors(KMD) who participated in the autumn symposium of the society of Oriental Obstetrics & Gynecology. Results : 1. The main Ob & Gy disease that the acupuncture treatment has been used actually or thought be positively necessary on the clinic were Dysmenorrhea(including premenstrual syndrome), Climacteric syndrome, Menstrual disorder, Postpartum Pain syndrome. Amenorrhea, Low back pain with pregnancy, JingHa(pelvic tumor), Infertility etc. 2. The main additional complex the sick and wounded names given to visiting patients for Ob & Gy disease as the limits of acupuncture items of insurance coverage were Low back Pain(J10), Qi-stasis(B13.0), SimHwaHangYeom(C2l.1). 3. Suitable the sick and wounded name of Ob & Gy disease thought be added in BokGangNae(Intra-abdominal acupuncture: CV13 ${\cdot}$CV16${\cdot}$CV10). TuJa(Puncture each adjoining acu-points in one insertion : SP6-GB39), TuJa(PC6-TE5) among acupuncture items of insurance coverage were Dysmenorrhea(K05). Menstrual disorder(K02) and Dysmenorrhea(K05), Hyperemesis(K16.0). 4. Climacteric syndrome(K04) and Dysmenorrhea(K05) should be added as suitable the sick and wounded name of TuJa(SP6-GB39), and Postpartum pain syndrome(K29) as KwanJeolGangNea(Intra-articular acupuncture: S35, LE201). Conclusion : Standing on this study, additional survey to general KMD should be continued. And the academic verifications through the oriental medical literatures and RCT papers on acupuncture should be also required.

• Journal of Digestive Cancer Research
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• 제11권2호
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• pp.104-107
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• 2023

The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

• 무역상무연구
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• 제27권
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• pp.129-161
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• 2005

Todays, computers in business world are potent facilitators that most companies could not without them, while they are only tools. They offer extremely efficient means of communication, particularly when connected to Internet. What I stress in this article is the risks accompanied by e-commerce rather than the advantages of Internet or e-commerce. The management of e-commerce companies, therefore, should keep in mind that the benefit of e-commerce through the Internet are accompanied by enhanced and new risks, cyber risks or e-commerce risks. For example, companies are exposed to computer system breakdown and business interruption risks owing to traditional and physical risks such as theft and fire etc, computer programming errors and defect softwares and outsider's attack such as hacking and virus. E-commerce companies are also exposed to tort liabilities owing to defamation, the infringement of intellectual property such as copyright, trademark and patent right, negligent misrepresent and breach of confidential information or privacy infringement. In this article, I would like to suggest e-commerce insurance or cyber liability insurance as a means of risk management rather than some technical devices, because there is not technically perfect defence against cyber risks. But e-commerce insurance has some gaps between risks confronted by companies and coverage needed by them, because it is at most 6 or 7 years since it has been introduced to market. Nevertheless, in my opinion, e-commerce insurance has offered the most perfect defence against cyber risks to e-commerce companies up to now.

• 보건행정학회지
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• 제20권3호
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• pp.104-122
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• 2010

Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

• 한국사회복지학
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• 제45권
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• pp.72-100
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• 2001

Despite the rapid expansion of social security coverage in the 1990s, many wage earners in Korea, especially the majority of the nonstandard workforce are excluded in the social insurance programs. In this regards, the purpose of this paper is to analyze causes of the exclusion of nonstandard workers to the social insurance scheme and to suggest the feasible policy options. Through this paper, four arguments are addressed as follows. First, the main issue for exclusion from coverage of those workers is that they have no entitlement to social insurance. This is not an issue of that they fall below hours or income thresholds for the entitlement Second, the top-down process of the extension in the Korean social insurances have divided the wage earners into two groups, the insider (the included) and the outsider (the excluded). Many nonstandard workers belong to the latter category. Third, the social insurance systems have been designed for the regular workers who were characterized by a full-time with some degree of stability. Reform designed to cope with the growth of nonstandard workers must build on the existing structure of social insurance. Finally, the governance capacity by social security administration body must be improved in order to provide a basic social protection for those workers. For that, four separated social insurance administration bodies could be unified to one administrative body, or tax and contribution of social insurance could be collected by one integrated administration body, the National Tax Service.

• 보건행정학회지
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• 제30권3호
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• 보건행정학회지
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• 제2권1호
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• pp.167-203
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• 1992

The effects of regional health insurance on access to ambulatory care are examined in this paper. Access is measured as use-disability ratios. The data are collected in a household interview survey at Hwachon county before and after the introduction of regional health insurance. Before the introduction of regional health insurance, low-income class has less contacts with physicians than high-income class. This disparity in accessibility among economic classes is reduced with the health insurance coverage, but not removed, even after adjusting for health need.

• 대한영양사협회학술지
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• 제16권4호
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.