• Title/Summary/Keyword: Medical Burden

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The Meaning and Criterion of Medical Malpractice(negligence) from Moderating the Burden of Proof in a Medical Malpractice Suit (의료과오소송에 있어 입증책임 완화에 따른 의료과실의 의미와 판단기준)

  • Kim, Yong-Bin
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.57-127
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    • 2008
  • In medical malpractice lawsuits, negligence is generally defined as conduct that is culpable because it falls short of what a reasonable person would do to protect another individual from a foreseeable risks of harm. Thus, the essence of negligence is a breach of obligations to be attentive, and the breach of obligations to be is negligence. However, whether negligence is or not depends on time, place, litigation forms and the judge since the meaning of negligence is wavering on the basis of abstract and normative judgment. In this thesis, what is medical negligence, a breach of obligations of attention for a doctor in medical malpractice lawsuits, would be it further enacted that doctors have the responsibility to protect the patients as a subordinate duty due to a principle of faith and sincerity besides the main duty for medical contract-performance since the suit is a litigation form to be based on responsibilities of experts, especially doctors, though having factors that are non-contractual as a trait for medical treatment. Further on the concept, when the plaintiff asserts and proves a specific fact from the recent moderation of the burden of proof about medical malpractices, whether the court should find a true bill in medical malpractice actually or not has been discussed.

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Anticancer Drug Use and Out-Of-Pocket Money Burden in Korean Cancer Patients: A questionnaire Study (국내 암환자의 항암제 사용 및 본인부담비용에 대한 실태조사)

  • Kim, Haesook;Jang, Jinkyung;Sohn, Hyun Soon
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.239-250
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    • 2012
  • In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.

Factors Affecting the Burden of Medical Costs for Inpatients (입원환자 의료비 부담에 영향을 미치는 요인)

  • Kwon, Lee-Seung;An, Byeung-Ki
    • The Korean Journal of Health Service Management
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    • v.6 no.4
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    • pp.143-152
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    • 2012
  • This study analyzes Korea health panel data (2008) (beta version 1.2) of Korea Institute for Health and Social Affairs, and National Health Insurance Corporation to figure out determinants of healthcare expenditure. In result of Multiple Logistic Analysis, in-patents felt burden on the medical expenditure were 70.0%. As to the patients' payment of medical expenditure, patients over 65 years old had 4.765 times higher than those under 14 years, disabled patients 2.778 than non-disabled patients, chronic patients 1.632 times than non-chronic patients, patients belonging to 12 million won ~ 46 million won and under 12 million won in family income had 1.680 times and 2.168 times respectively than patients with over 46 million won, patients in professional recuperation facility 1.546 times than patients in hospital, patients in private medical institutions 1.700 times than patients in national and public medical institutions, patients using upper grade rooms 1.701 times than patients in non-upper grade rooms. As a health care safety net mechanism to protect people from medical expenditure burden, there is the patients' payment ceiling in the National Health Insurance System. Thus, in order to facilitate the patient's payment ceiling, it is required that the level of ceiling is to be specified according to the income level, and self-payment items is to be included.

Cancer Care Burden among Primary Family Caregivers of Iranian Hematologic Cancer Patients

  • Abbasnezhad, Masoomeh;Rahmani, Azad;Ghahramanian, Akram;Roshangar, Fariborz;Eivazi, Jamal;Azadi, Arman;Berahmany, Golshan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5499-5505
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    • 2015
  • Background: Providing care for hematologic cancer patients may lead to many negative complications in different aspects of life in their family caregivers. Based on a wide review of relevant literature, there are limited data about the burden of giving care for hematologic cancer patients on their primary family caregivers in Iran or other Middle Eastern countries. Therefore, the aim of this study was to investigate the cancer care burden on primary family caregivers of hematologic cancer patients, in terms of physical, psychological, social, spiritual, and financial aspects. Materials and Methods: In this descriptive study, 151 primary family caregivers of hematologic cancer patients referred to two cancer care centers in East Azerbaijan Province in northwest of Iran participated. The Financial Distress/Financial Well-being Scale, Hospital Anxiety and Depression Scale, Vaux Social Support Questionnaire, Spiritual Well-being Scale, and SF-36 were used for data collection. Data analysis was performed with SPSS software. Results: The findings of this study indicated that the primary family caregivers experience a high level of financial distress and a significant percentage of them suffered from anxiety and depression. In addition, the physical quality of life in these caregivers was moderate. On the other hand, spiritual health and social support of participants was at an acceptable level. Conclusions: Iranian primary family caregivers of hematologic cancer patients experience many problems in physical, psychological, and financial aspects of their life. Therefore, developing care plans for reducing these problems appears necessary.

The Effect of Private Health Insurance on the Subjective Burden of Medical Expenses (민간의료보험 가입 여부가 본인부담 진료비의 주관적 부담 수준에 미치는 영향)

  • Hong, Jin Hyuk;Noh, Jin-Won;Park, Kisoo;Lee, Yejin;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.63-70
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    • 2017
  • Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

The Burden of Stroke in Kurdistan Province, Iran From 2011 to 2017

  • Moradi, Shahram;Moradi, Ghobad;Piroozi, Bakhtiar
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.2
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    • pp.103-109
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    • 2021
  • Objectives: The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017. Methods: Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs). Results: The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively. Conclusions: The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

A study on the Shift of Burden of Proof in Medical Malpractice - Ruling of Jeonju Appellate Court 2017Na9346 - (의료과오소송에서의 증명책임에 대한 소고 -전주지방법원 2017. 7. 21. 선고 2017나9346판결-)

  • Lee, Soo-Kyoung;Yoon, Seok-Chan
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.49-79
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    • 2021
  • Due to defendant's wrongful act by implant surgery, plaintiff has been suffered serious damages to his face and teeth, and pain caused by establishing implanted teeth. Jeonju Appellate Court sentenced to pay future medical expenses and alimony to the plaintiff in compensation for breach of duty or torts. The ruling is designed to relieve the burden of proof because it is extremely difficult for non-experts to determine whether dentists violated their 'duty of care' or whether there was a causal relationship between damages to medial treatment. It was judged that if symptoms that contributed to the patient's significant outcome occurred during or after surgery, such symptoms could be presumed to have been caused by medical negligence if indirect facts were proven to be other than medical negligence. Originally, the shifting of burden of proof in Germany, has already been developed in medical malpractice case since 1940s. In order to guarantee the patients' right, §630h German Civil Code (BGB) - presumption of negligence in the realization of controllable risk- has been also legislated. BGH (Bundesgerichtshof) has been interested in ensuring that the principle of equality between patients and doctors. So, in this study, we wanted to refer to German precedent cases to analyzing Korean medical malpractice lawsuit. In particular, the decision could be significant in that it approaches closer to allows the shifting burden of proof in drastically growing dental malpractice cases. This is clearly confirmed in the judgment of the dentist's "fault" that "if indirect facts about the symptom or occurrence are proven to be cause other than medical negligence, such symptoms can be presumed to be due to medical negligence."

Association between caregiving activities and care burden among caregivers of people with dementia

  • Park, Eun-Ju
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.11 no.4
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    • pp.346-354
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    • 2018
  • The purpose of this study was to examine the difference in the association between caregiver's activities and caregiving burden according to gender and family relationship of caregivers of older people with dementia. This study used data from the Caregivers of Alzheimer's Disease Research survey (n=476). The association between caregiving activities and care burden was analyzed by multiple regression. In this study, the caregivers were predominantly spouses, followed by daughters. The care burden, especially personal burden, and depression were significantly higher in women than men. The spouses (either male or female), compared with the sons and daughters, spent significantly more time providing care. Care time and depression of caregivers and physical disability of the patient were significantly correlated with care burden. Among the caregiving activities, using transportation, dressing, eating, looking after appearance, and supervising were significantly associated with care burden. The daughters and daughters-in-law presented more care burden with higher number of care days, and the female spouse who were younger tended to experience higher care burden. Daughters who provided longer time looking after appearance exhibited higher care burden. For female spouse, eating time was significantly associated with care burden. The association between caregiving activities and care burden of caregivers of people with dementia differed by gender and family relationship with the patient. This study was characterized by analyzing the effect of caregiving activities on caregiving burden by gender and family relationship of caregivers.

Head and Neck Cancer: Global Burden and Regional Trends in India

  • Mishra, Anupam;Meherotra, Rohit
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.537-550
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    • 2014
  • The actual burden of head and neck cancer in India is much greater than reflected through the existing literature and hence can be regarded as a 'tip of iceberg' situation. This has further been evident by the recent reports of 'Net-based Atlas of Cancer in India'. South-east Asia is likely to face sharp increases of over 75% in the number of cancer deaths in 2020 as compared to 2000. Since the percentage increase of Indian population has been nearly twice that of the world in last 15 years there is a likelihood of increase in cancer burden with the same proportion. The distribution of population based cancer registries is grossly uneven with certain important parts of the country being not represented at all and hence the current cancer burden is not reflected by registry data. However, the pathetic situation of health care system in major parts of the country as also emphasized by the World Bank, is not suitable to provide anywhere near accurate data on cancer burden. Head and neck cancer (including thyroid lesions) is third most common malignancy seen in both the sexes across the globe but is the commonest malignancy encountered in Indian males. Also oral cavity cancer is the most prevalent type amongst the males and one of the highest across the globe. This article reviews the latest global and national situation with an especial emphasis on head and neck cancer. Furthermore this review focuses on burden in different sub sites at national and global levels.