• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.405-406
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• 1996

• Journal of Arbitration Studies
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• v.26 no.4
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• pp.129-149
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• 2016

Medical dispute means the dispute between the hospital and the patient due to a medical accident. In general, medical accidents must be in accordance with the terms that are used in the medical dispute adjustment method stated in Article 2 (definition). In relation to this, there is a need to discuss an efficient operation scheme for Alternative Dispute Resolution (ADR) in medical disputes. In addition, it is necessary to look at issues of civil liability and criminal liability. In particular, in the consumer dispute arbitration committee, there is a case to make a "decision not to adjust" in aggressive intervention in the process of conflict resolution. The medical staff, on the basis of its "decision," can use this as a proven material for civil and criminal cases. This is rather upon the determination of the consumer council as a typical side effect to defend the user's perspective. This is the "decision" as was expressed from an order, "not adjusted." It is also determined to be easy and clearly timely. In the medical litigation, it is requesting the burden of proof of a patient's cause-and-effect relationship with the doctors committing negligence and medical malpractice. This seems to require the promotion of legislation in the direction to reduce future cases. It is determined that the burden of proof of medical accidents must be improved. The institution receiving the medical accident should prevent a closure report. Further, it is necessary to limit the transition to a franchise point. In this paper, we understand the problems of the current medical dispute resolution system, trying to establish a medical dispute resolution system desirable through an efficient alternative. In addition, it wants help in the protection and realization in medical consumers' and patients' rights. The relevant authorities will take advantage of these measures. After all, this could contribute to the system for a smooth resolution of a medical dispute.

• The Korean Society of Law and Medicine
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• v.15 no.2
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• pp.435-459
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• 2014

Supreme Court of Korea has been mitigating the burden of proof on the malpractice and causal relation by a patient in accordance with the practical transfer of such burden of proof on causal relation as well as relieving a doctor's burden of proof on mistake in the civil damage claim suits on the malpractice. However, a prosecutor shall strictly prove the causal relation between malpractice and unfavorable results as well as a doctor's mistake in the criminal cases for making a doctor accept the professional negligence resulting in death or injury in accordance with In Dubio Pro Reo principles. Furthermore, it shall not be allowed to relieve the burden of proof on malpractice and causal relation which has been frequently applied in the civil proceedings. Nevertheless, it was widely known that the front-line courts accepted the malpractice and causal relation by quoting the legal principles on relieving the burden of proof on malpractice and causal relation applied in the civil cases even in criminal cases with no or insufficient proof on malpractice or causal relation. However, the latest precedents in Supreme Court explicitly declared the opinion that there was no reason to apply the legal principle to relieve the burden of proof on the malpractice and causal relation in the criminal cases requiring the proof 'which doesn't cause any reasonable doubt' on malpractice and causal relation in accordance with the legal principles 'favorable judgment for a defendant in case of any doubt' on the basis of the strict principle of 'nulla poena sine lege.' Accordingly, Supreme court definitely clarified that there would be no reason to relieve the burden of proof on malpractice and causal relation in criminal cases by reversing several original judgments accepting malpractice and causal relation even though there were no strict evidence.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.195-204
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• 2007

It is a general principle that the plaintiff takes burden of proof about negligence and causation in a civil compensation litigation. And it is the same in a medical malpractice lawsuit. Korean courts have made diverse efforts to mitigate the plaintiff's duty to prove in medical malpractice lawsuits under the name of justice and impartiality. One of those theoretical attempt is 'presumption of causation'. The Supreme Court, since 1995, has developed a new logic for the theory of 'presumption of causation' which is characterized by a phrase "layman's common sense". The Court presumes the defendant's negligence and causation when the plaintiff alleges and proves the facts which can be pointed out and expressed by a layman with common sense. And if the defendant fails to prove that the result was caused by other fact than own medical activities, the defendant shall be defeated. I realize that this theory has problem for justice and impartiality. I would say that two fators should be considered and added to this logic. First,are defendant's acts generally belonging to gross negligence which would cause that kind of bad result? Second, is it recognized that there would be the causation generally and statistically between the cause and the result?

• The Journal of Korean Society for School & Community Health Education
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• v.15 no.3
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• pp.95-103
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• 2014

Objectives: To identify work stress and affecting factors of the emergency medical technicians(EMT) and to provide basic data for work circumstance improvement and emergency medical service and duty efficiency elevation. Methods: The data were collected by questionnaire from 635 emergency medical technicians throughout the whole country from August 5 to September 20 2013 and analyzed by using the SPSS(version 18.0) program. Factors affecting stress were analyzed by Multiple Linear Regression Analysis(${\alpha}=0.05$). Results: Mean level of job stress was markedly high in the spot situation(3.43 point), user awareness(3.31 point), burden related to work(3.21 point), role and conflict as a professional job(3.10 point), unsuitable treatment(2.95 point) but was lowest in specialty demand of knowledge and skill(2.76 point). Conclusions: To diminish work stress, understanding and cooperation of the residents and reduction of burden related to work must be improved. Above all, positive interest of 119 and related organ and duty environment improvement will and effort and continuous measure establishment and support and cooperation of the government are needed.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1123-1130
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• 2018

Purpose: Exposure to indoor radon is associated with lung cancer. This study aimed to estimate the number of lung cancer deaths attributable to indoor radon exposure, its burden of disease, and the effects of radon mitigation in Korea in 2010. Materials and Methods: Lung cancer deaths due to indoor radon exposure were estimated using exposure-response relations reported in previous studies. Years of life lost (YLLs) were calculated to quantify disease burden in relation to premature deaths. Mitigation effects were examined under scenarios in which all homes with indoor radon concentrations above a specified level were remediated below the level. Results: The estimated number of lung cancer deaths attributable to indoor radon exposure ranged from 1946 to 3863, accounting for 12.5-24.7% of 15623 total lung cancer deaths in 2010. YLLs due to premature deaths were estimated at 43140-101855 years (90-212 years per 100000 population). If all homes with radon levels above $148Bq/m^3$ are effectively remediated, 502-732 lung cancer deaths and 10972-18479 YLLs could be prevented. Conclusion: These findings suggest that indoor radon exposure contributes considerably to lung cancer, and that reducing indoor radon concentration would be helpful for decreasing the disease burden from lung cancer deaths.

• Journal of the Korean Society of Hazard Mitigation
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• v.11 no.1
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• pp.29-35
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• 2011

This study not only investigates emergency medical personnel's posttraumatic stress(PTS), social support, work burden, and coping style but also identifies related factors which were exerted influence on PTS and active coping method of emergency medical personnels among the firefighters. The data were gathered from 143 emergency medical personnels who were receiving training. The data were collected by IES-R, consisting of twenty-two questions that determine the level of PTS, method used in Cho's research(2000) that deal with work burden, method used in Oh's article (2006) relating to social support, and sixty-two questions that deals with coping methods. Then the data gathered were analyzed using SPSSWIN 14.0 program. PTS of general characteristics showed significant difference in age, marriage status, education, and position. High risk group of PTS was 74(51.7%). Work burden, active and passive coping method, and three symptoms in PTS are significantly high(p=0.000) in high risk group. PTS was correlated with work burden(r=0.508, p=0.000), active coping method(r=0.375, p=0.000), and passive coping method(r=0.505, p=0.000) but not with social support. Related factors of PTS were work burden(0.371) and passive coping method(0.366). Also related factors of high risk group of PTS were work burden(odds ratio=1.064, 95% confidence interval:1.031-1.103) and passive coping(odds ratio=1.050, 95% confidence interval:1.022-1.080). Related factors of active coping method were PTS(0.392) and social support(0.158). To minimize the PTS of emergency medical personnels, the new policy should decrease their work burden and passive coping method and strengthen the social support to encourage active coping method.

• Korean Journal of Health Education and Promotion
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• v.33 no.4
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• pp.1-9
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• 2016

Objectives: This review is to suggest strategies to reduce risk factors of non-communicable diseases (NCD) in South Korea. Methods: Prior research findings on the burden of NCD and associated risk factors and the effectiveness of intervention programs were reviewed. Strategies regarding the control of NCD risk factors were conceived. Results: The author presented research findings from the Global Burden of Disease study on the burden of non-communicable disease (NCD) and associated risk factors in South Korea. Strengths and limitations of population and high-risk strategies for preventing NCDs were introduced. The author also reviewed the evidence on the effectiveness of multiple cardiovascular risk factor interventions and community-based intervention programs on cardiovascular diseases conducted in industrialized countries. Finally, strategies to reduce NCD risk factors in South Korea were suggested. Conclusions: The evidence-based interventions and the importance of population strategies in NCD prevention were highlighted. The author indicated that strategies employed by unhealthy commodity industries to undermine effective public health policies and programs should be actively monitored. It has been suggested that effective high-risk strategies with ecological models to address social risks rather than medical risks among disadvantaged population should be further developed in South Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4015-4023
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• 2013

Cancer of the cervix is the third most common cancer in women worldwide, more than 85% of the cases occurring in developing countries such as China. In China, since a national cancer registry is already set up but with geographically limited data generated, the burden of cervical cancer is believed to be underestimated. High-risk human papillomavirus (HR-HPV) prevalence among women attending routine cervical cancer screening programs has been shown to correlate well with cervical cancer incidence rates based on independently obtained HPV prevalence data as well as findings for the worldwide cervical cancer burden. Therefore, reviewing data on HR-HPV prevalence in population-based screening studies and hospital-based case studies will be important in the context of better understanding the cervical cancer burden and for the evaluation of the potential impact of HPV vaccination in the country. With the advent of prophylactic vaccines, significant progress is likely to be made in cervical cancer prevention. This article reviews available data on the HPV epidemiology over a 12-year time period (2001-2012) in mainland China under different epidemiological aspects: by age group of study population, by ethnicity, by geographic area, as well as time period. The authors also review the potential acceptability of HPV vaccination among Chinese women.