• 의료법학
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• 제15권2호
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• pp.345-366
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• 2014

Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.

• 의료법학
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• 제16권2호
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• pp.227-261
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• 2015

협동조합은 조합원의 권익을 향상시키고 지역사회에 공헌하는 것을 목적으로 만들어진 조직을 의미하는 것으로 실제로 지역사회에 많은 기여를 하고 있다. 그리고 이중에서 특히 소비자들이 상부상조의 정신에 입각하여 공동의 복리향상을 도모하기 위하여 자발적으로 설립한 조직이 소비자생활협동조합이다. 한편, 의료법에 의하면 비영리법인에게 의료기관을 개설할 자격을 부여하고 있으므로 소비자생활협동조합이나 협동조합기본법에 따라 설립된 비영리법인인 협동조합은 의료기관을 개설할 자격이 있다. 그런데 애초 사회적 약자인 구성원들의 공동의 이익을 위해 조직되어야 할 협동조합이 의료기관 개설자격을 부여받기 위한 탈법적인 수단으로 악용되는 사례가 증가하였다. 특히 국민건강보험공단이 의료법상 의료기관을 개설할 수 없는 자가 의료인을 고용하여 의료기관을 개설하는 이른바 사무장병원에 대한 조사와 부당이득징수가 강화되자, 이에 따른 우회적인 회피수단으로 의료협동조합을 설립하여 의료기관을 개설하는 수가 급증하였다. 따라서 본 고에서는 우선 의료협동조합의 개설을 규율하고 있는 이원화된 현행 규범체계를 소개하고, 이를 통해 상대적으로 취약한 부분 내지 제도개선이 이루어져야 할 부분을 살펴보고자 한다. 그리고 의료협동조합의 개설 운영, 폐업 현황 및 법령위반 내용 등을 체적으로 확인함으로써 현행 의료협동조합개설 운영에 대한 규범적 제도적 개선방안을 제시하고자 한다.

• 의료법학
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• 제23권3호
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• pp.47-87
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• 2022

코로나19 감염병 확산으로 인해 비대면진료가 일시적으로 허용되었고 지속 필요성에 대한 공감대가 커지고 있다. 그러나 현행 「의료법」은 의사와 의료인 간의 원격의료만 허용하고 있다. 비록 법률해석을 통해 의사와 환자 간의 비대면진료가 허용된다는 의견도 있지만 전체적인 법률체계를 고려할 때 허용되지 않는 것으로 보는 것이 타당하다. 그럼에도 불구하고 과학기술의 발달과 감염병 출현 시기의 단축 등을 종합적으로 고려할 때 앞으로 대면진료만을 고집하는 것은 바람직하지 않다. 따라서 안전하고 효과적인 비대면진료가 이뤄질 수 있는 방안을 고민하고 제도화하는 것이 전략적으로 필요하며, 또 중요하다. 이를 위해 앞으로 논의되어야 할 법률적 쟁점들을 미리 살펴보는 것이 이 글의 목적이다. 비대면진료를 구체적으로 규율하기 위해서는 우선 비대면진료의 범위와 대상 질환 그리고 시행 주체가 명확해야 한다. 또한 비대면진료가 시행되기 위해서는 구조적으로 시설과 장비 기준이 마련되어야 하고 기능적으로는 해당 시설과 장비를 통해 의사와 환자가 적극적으로 소통하고 정보를 실시간 교환할 수 있어야 하고 비대면진료 과정에서 발생하는 정보를 보호하기 위한 관리체계가 구체적으로 마련되어야 한다. 이처럼 비대면진료를 시행하기 위해 새롭게 정비되어야 할 내용뿐만 아니라 비대면진료를 통해 발생할 수 있는 책임의 문제와 비용의 문제도 구체적으로 정리될 필요가 있는 법적 쟁점이다.

• 한국응급구조학회지
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• 제24권3호
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• pp.79-87
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• 2020

Purpose: This study sought to determine how the act of performing cardiopulmonary resuscitation (CPR) affects the rescuer's muscle tone, stiffness, and fatigue in the lumbar region. Methods: The research subjects were 30 healthy men in their twenties in possession of a Basic Life Support (BLS) provider certificate. In this study, the CPR rescuer's muscle tone and stiffness in the upper and lower lumbar regions were measured in the resting position, starting position, and position after 10 min. Their level of fatigue was measured before and after performing CPR. Results: Muscle tone and stiffness in the upper and lower lumbar regions of the research subjects significantly increased throughout the CPR process and lasted up to 10 min after the process (p<.001). The subjects' fatigue also significantly increased post-CPR (p<.001). Conclusion: This study suggests that performing CPR creates muscular and physiological stress, fatigue, and ultimately, lower back pain.

• 의료법학
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• 제22권3호
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• pp.31-55
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• 2021

개정 데이터 3법 중 하나인 개인정보 보호법은 가명정보의 처리에 관한 특례 규정을 신설하였다. 이에 개인정보처리자는 과학적 연구, 통계작성, 공익적 기록보존 등의 목적을 위해서 정보주체의 동의 없이 가명정보를 처리할 수 있게 되었다. 그리고 개정 개인정보 보호법의 후속 조치로 의료 분야의 개인정보 가명처리를 다룬 '보건의료 데이터 활용 가이드라인'이 마련되었다. 가이드라인은 보건의료 데이터의 특성을 고려한 구체적인 해석과 사례를 규정함으로써 수범자들에게 실천적인 기준을 제시한다는 점에서 의미가 있다. 다만 가이드라인은 가명정보 활용 목적을 명확히 하고, 데이터 심의위원회 구성의 공정성을 강화할 필요가 있다. 또한 가이드라인은 보건의료 데이터 보상 체계를 구축하고, 취약 연구대상자의 권리 보호 강화가 요구된다. 아울러 가이드라인은 생명윤리 및 안전에 관한 법률, 의료법과의 부정합성을 정비할 필요도 있다. 본 연구가 보건의료 데이터 활용의 안전한 환경 조성은 물론 관련 법과 제도의 개선에 기여할 것으로 기대한다.

• 의료법학
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• 제15권1호
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• 의료법학
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• 제13권1호
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• pp.71-89
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• 2012

Just in case a patient's state couldn't get better or get even worse after medical practices, it is difficult for the patient's side to accept the result and it tends to think that its damage is caused by his doctor's malpractice. Medical practices of a doctor require highly advanced attention duty as a medical expert, because they are targeted at a human body of the best benefit and protection of the law. However, it is hard to prove the malpractice on the patient's side in medical dispute. Therefore, to solve a medical dispute quickly and fairly before the medical suit Korea Consumer Agency (KCA) has done a medical dispute adjustment business since 1999. For the past 5 years (2006~2010), the medical team of KCA had managed 4,171 cases as an injury relief, but it had dealt with them focusing on an injury relief business only after the occurrence of a medical accident. Afterwards, it is necessary to expand the range of its services in purpose of preventing the injury of consumers. If we can solve the problems -the clear statements about the cease of extinctive prescription in the fundamentals of comsumer act, the presence of parties directly concerned at comsumer dispute adjustment committee, and the effect of an agreement, etc. -, which have been founded in medical injury relief service of KCA and the management and procedures of the comsumer dispute adjustment committee of KCA and if we can also give KCA more workers and the proper budget of the government, we can expect KCA to become a more useful agency.

• 보건의료산업학회지
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• 제3권2호
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• pp.65-75
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• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on a general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization. And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea. And it was understood that most of residents within a distance of 40 minute by the public transportation were using. Although there are restrictions that the analyses were carried out for a general hospital in a province, the findings of this study can be considered a generalized model for the management of provincial general hospitals when we consider the current circumstance that the diagnosis and treatment are carried out by provincial medical institutions primarily for patients in general within the province, along with implications that any general hospital in Korea should be equipped with the facilities, equipments and human resources under the Medical Treatment Act.

• 한국보건간호학회지
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• 제33권3호
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• pp.311-325
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• 2019

Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.

• 대한안전경영과학회지
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• 제12권3호
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• pp.61-72
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• 2010

Judgment of cerebral and cardiovascular diseases arising out of duty follows the legal judgment method for the purpose of investigation of medical causes based on the Industrial Accident Compensation Insurance Act, with the characteristics of the occurrence as personal factors etc. act as risk factors while work-related ones as triggers, in the case of disease due to occupational cases, as whether it arose out of duty must be judged including even the individual's personal risk factors, there are limitations securing fairness even with existing laws, regulations and guidelines. This study was carried out to suggest basic data for the preparation of standardized guidances for diseases arising out of duty by reviewing the standards for the acknowledgment of cerebral and cardiovascular diseases due to occupational cases, and it has a significance in that it suggests target diseases that may be judged as cerebral and cardiovascular diseases, legal criteria for the acknowledgment and standards for the judgment of cerebral and cardiovascular diseases arising out of duty.