• Title/Summary/Keyword: Oriental health insurance

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Review of 2022 Major Medicla Decisions (2022년 주요 의료판결 분석)

  • Lee Jeongmin;Yoo Hyunjung;Park Taeshin;Jeong Heyseung;Cho Woosun;Park Nohmin
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.79-117
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    • 2023
  • Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.

Qualitative Analysis of Medical Usage Patterns of Medical Aid Patients (의료급여환자의 의료이용행태에 관한 질적 분석)

  • Park, Young-Hee;Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.17 no.9
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    • pp.39-49
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    • 2017
  • This was a qualitative study on medical aid patients to understand the cause and process of statistical difference of health service utilization between medical aid and health insurance patients. The main results were the following; 1) There was few overuse of health service in medical aid patients. The reason of heavy utilization was mainly due to the complicated disease. Some of them were considered to overuse physical therapy and oriental acupuncture. 2) In case of medical aid patients, medical cost was paid by their welfare benefit of government or by the support of family or neighbors. They usually could not adequately use the services of uninsured benefit or large hospitals due to the cost. Some patients just endured the pain. There was still discrimination for medical aid patients in some medical institutions. 3) The health officials and institutions did not provide sufficient information to medical aid patients about the policy of medical cost support. 4) Health policies, such as selective clinic system, medial aid case management, approval of extended care, were considered to contribute in preventing unnecessary use of health service. However, this might limit adequate use of medical aid service. In conclusion, there is little evidence of overuse of health service for medical aid patients, which is different from the previous studies. A new plan is necessary, because medical aid patients thought that the necessary health service was not accessible to them.

A Study for Usage Patterns and Recognition toward Korean Medicine in Korea High School Students (고등학생의 한의약 의료 이용 형태 및 인식에 관한 연구)

  • Jung, Sung-Hun;Kim, Gi-Ryang;Jeong, Joon-Soo;Sung, Hyun-Kyung;Lee, Ju-Ah;Kang, So-Hyeon;Kim, Young-Ji;Kong, Kyung-Hwan;Go, Ho-Yeon
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.1
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    • pp.19-28
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    • 2016
  • Objectives : This study is to research on usage patterns, recognition of system to Korean medicine among high school students who are the potential future medical consumer. Methods : Based on the questionnaire used by KIHASA(Korea Institute for Health and Social Affairs) in 2011 and KHIDI(Korea Health Industry Development Institute) in 2014, modifications were made to make questionnaire more suitable for this research. This self-administered questionnaire was conducted among 1,025 highschool students of 3 high schools in Ulsan city on september, 2015. Except 19 cases which considered statistically insignificant or with unreliable responses, 1,007 cases were analyzed by p-paired test and ANOVA test through the SPSS 22.0 for Win program. Results : Most of the high school students(66.5%) do not have an experience on Korean medical care. The number of students' first experience on Korean medical care is the largest during their elementary school (34.9%), which means the treatment was mostly for restorative reasons like growth care. The later the time of their first experience on Korean medical care, the higher ratio was shown on their recent utilization of Korean medical care. Korean medicine was rarely covered in most cases of public health education at school, and this public health education and usage pattern on Korean medicine have positive correlation. Compared 'Group who have used Korean medical care in 1 years except recent 3 months' to the 'Group who have used Korean medical care in 3 recent months', the former showed higher recognition in Korean medical care and insurance system. Conclusions : The proportion of Korean medicine is as low as 4.5% to whole medical market, and most of the consumers are senior. In addition, the aging phenomenon of Korean medical consumer have been continued. This specialized study on usage patterns and recognition among youth can be the basic research data which can be used for promotion, education and establishment of health policy and health care system.

A Study of Complementary and Alternative Medicine used by Cancer Patients in Korea (우리나라 암환자가 이용하는 보완·대체요법에 관한 연구)

  • Chang, Soon-Bok;Lee, Tae-Wha;Kim, Soyaja;Yoo, Il-Young;Kim, In-Sook;Kang, Kyeong-Hwa;Lee, Mi-Kyeong;Jang, Young-Hee
    • Korean Journal of Adult Nursing
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    • v.18 no.1
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    • pp.92-101
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    • 2006
  • Purpose: The purpose of this study was to study complementary and alternative medicines (CAM) used among cancer patients in Korea. Method: This study was a descriptive survey. Study participants were 1,150 cancer patients selected from 28 representative hospitals in Korea. Data were collected between December 1, 2004 and March 30, 2005. Results: Their diagnosis were as follows : 20.0% for breast cancer, 15.6% for stomach cancer, 14.4% for liver cancer, 10.8% for lung cancer, 10.0% for colon cancer, and 10.0% for uterine cancer. 75.0% of cancer patients had used CAM. The most popular categories of CAM use were diet with 153.2%, non- prescription of oriental medical doctor 47.9% and mind-body control 20.3%. CAM use gender, age, cancer type, cancer treatment method, and current treatment type was significantly different in. Conclusion: CAM use among cancer patients in Korea was very popular(75.0%) and so systemic guidelines of CAM use are needed.

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Assessment of Validity of Inpatient Classification System in Korean Medicine (KDRG-KM) (한의 입원환자분류체계의 적정성 평가)

  • Kim, Dongsu;Ryu, Jiseon;Lee, Byungwook;Lim, Byungmook
    • The Journal of Korean Medicine
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    • v.37 no.3
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    • pp.112-122
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    • 2016
  • Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.

A Study on Major Uninsured Korean Medicine Treatments Search Trends and Their Meanings in an Online Portal: Using Naver Data Lab (온라인 포털에서의 주요 비급여 한의치료 검색 트렌드와 그 의미에 대한 고찰: 네이버 데이터랩을 이용하여)

  • Chan-Young Kwon
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.74-86
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    • 2023
  • Objectives: The purpose of this study was to examine search trends and their meanings for major uninsuired Korean medicine (KM) treatments through analysis of an online portal search results. Methods: Keywords searches were performed using Naver Datalab on 4 July 2023. From January 2016 to June 2023, monthly relative search volume (RSV) for keywords 'pharmacopuncture', 'Chuna', and 'needle-embedding therapy', and 'herbal decoction' were extracted with a score between 0 and 100. For the obtained RSVs, longitudinal changes over time, characteristics according to sex and age group, and correlations between them were investigated. Results: The ranking of RSV for each keyword has changed from 'Chuna', 'herbal decoction', 'needle-embedding therapy', and 'pharmacopuncture' to 'Chuna', 'herbal decoction', 'pharmacopuncture', and 'needle-embedding therapy' after 2019. Overall, the RSV of needle-embedding therapy continuously decreased, while that of pharmacopuncture continuously increased. In 2019, a rapid increase in the RSV of Chuna was observed, and in 2020, a rapid increase in the RSV of herbal decoction was observed. There was a difference in the longitudinal change pattern of RSV for the keywords by age group. Importantly, in the elderly, changes in RSV were observed in a favorable pattern to KM treatment. Conclusion: Our findings enable estimation of the public's interest and its changes for the four uninsuired KM treatment, and can be used as basic data to strengthen health insurance coverage in Korea. Specifically, changes in interest in KM treatments according to sex and age can be referred to.

A Study on the Curriculums of the Nursing Department of Junior Colleges in Seoul and Kyungin Area (간호교육 개선을 위한 교과과정 비교분석 - 서울$\cdot$경인지역 전문대학을 중심으로 -)

  • Lee Ae Kyung;Kim Jung Ae;Phang Suk Mung;Joo Mi Kung;Kim Young Hee;Chung Ann Soon;Choi Na Young;Chang Eun Jung
    • Journal of Korean Public Health Nursing
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    • v.11 no.2
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    • pp.180-193
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    • 1997
  • This study was designed to set up more developed curriculum in Nursing department of a junior college. The sample for the study were fifteen curriculums of fifteen selected junior colleges in Seoul and Kyunggi area. The credits and hours of each curriculum were analyzed into means and compared with the one of the example college. The data were categorized into seven sections; cultural subject, basic medical science, major subjects such as Nursing, Fundamental Nursing, electives, teaching and non-teaching subjects, and clinical practice. The data were analyzed by means of descriptive statistics. The results of the study were as follows; 1. Credit hours of Cultural subjects of each college ranges from $5.8\%\;to\;25.7\%$ of the total graduate credit hours; most commonaly lectured subjects are English 05 colleges), Korean (11 colleges), psychology (10 colleges), and computer (10 colleges). 2. In the case of the example college, Anatomy and Psychology were jointed as one subject, Basic Nursing Science, and some more study in depth should be made to develop more of this type of conjunction among related subjects on basic medical science. 3. As for the mendatory subjects of the example college, subjects on Adult Nursing was fourteen credits (14 hours), which was higher than the average 12.9 hours of other colleges compared. 4. Credit hours of Basic Nursing Laboratory were eight to ten credits (12-18 hours), which was higher than actual class hours. As more and more hospitals test clinical aptitude when recruiting nurses, more emphasis should be paid to the clinical practice. 5. Among fifteen sample curriculums six to twelve electives were offered with twelve to twenty-three credits. Most commonly opened subjects were Physical Examination (5), Nursing English (14). and Geriatrics Nursing (13). Nursing English are considered to be more important in the view of clinical practice. and Oriental Nursing, Nursing Information and Health Insurance Management should be considered as specialized subjects. 6. Teaching and Non-teaching subjects In case of the example school. Clinical Emergency Medicine, Introduction to Emergency Medicine were offered for these non-teaching class students so they could prepare for the qualification examination. 7. Clinical Practice The average credit hours for clinical practice of the sample college were 20.9 credit hours $(66.5\%)$ and the example school offered twenty credit hours which was slightly lower than the other forteen.

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The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

A Study On The Attitudes Toward Death -For Nursing Care of The Terminally Ill- (죽음의 태도에 관한 조사연구 -임종환자의 간호를 위하여-)

  • 유계주
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.162-178
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    • 1974
  • The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

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The Risk of Onset of the Illnesses Based on Gender, Age, and Monthly Income;Focusing on cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders (성별, 연령별, 월소득차이에 따른 질병발생의 위험성 차이연구;암, 고혈압, 중풍, 당뇨병, 관절염, 심장병을 중심으로)

  • Lee, Jun-Oh;Kim, Se-Jin;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.1
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    • pp.19-48
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    • 2008
  • In order to verify the risk of onset of the illnesses based on gender, age, and monthly income 1,739 subjects from Hongcheon county, Gangwon province were selected. Questionnaire on demographic sociology, health condition, existence of illnesses(cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders), and usage of public health services was surveyed from October 1, 2006 to October 20, 2006. Following conclusions were reached on the basis of the questionnaire : - For demographic sociological peculiarities, gender, age, occupation, and education level were evenly distributed. Most were under normal marriage(67.38%), health insurance(86.39%), 494(36.0%) individuals with less than monthly income of 1 million won, 494(36.0%) individuals with monthly income between 1 and 2 million won, 219(16.0%) with monthly income between 2 and 3 million won, and 164(12.0%) individuals with more than 3 million won, thus showing relatively low income. - For health status, 1,199(70.28%) individuals are non-smokers, 209(45.63%) individuals smoke $10{\sim}20$ cigarettes a day, 754(44.02%) individuals exercise less than twice a week are the major sector of the population. 1,518(88.10%) individuals have regular checkup more than once and 1,131(65.49%) stated their health condition less than average. - For comparison of existence of illnesses between genders, there was no statistical significance on cancer, stroke, and diabetes. But statistical significance was shown on hypertension(P value 0.025), arthritis(P value 0.000), and cardiac disorders(P value 0.016). Statistical significance was seen in the age comparison, and OR(confidence interval) drastically increased with increase in age. - There was no difference between the primary health clinic(P value 0.000), most visited clinic(P value 0.000), selection criteria(P value 0.000), and satisfaction on efficacy(P value 0.000). There was a tendency preferring hospital than public health center with increase in income. - For correlation between the existence of illnesses among different income levels, except for cancer(P value 0.172), statistical significance was seen in hypertension(P value 0.000), stroke(P value 0.003), diabetes (P value 0.001), arthritis(P value 0.000), and cardiac disorders(P value 0.000). The number of individuals suffering from illnesses and ratio all decreased for all illnesses with increase in income. - After adjusting confounding factors(gender, age, income, marriage, occupation, education) and male (1) as the standard, OR (confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 0.47(0.11${\sim}$2.05), 1.27(0.89${\sim}$1.81), 0.58(0.21${\sim}$1.59), 0.71(0.41${\sim}$1.23), 1.79(1.34${\sim}$2.39, P<0.01), and 1.46(0.72${\sim}$2.96), respectively. Risk of arthritis is significantly high in female and 20's (1) as the standard, OR(confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 1.01(0.96${\sim}$1.07), 1.06(1.04${\sim}$1.07, P<0.01), 1.05(1.01${\sim}$1.10, P<0.01), 1.06(1.03${\sim}$1.08, P<0.01), 1.05(1.03${\sim}$1.06, P<0.01), and 1.06(1.04${\sim}$1.09, P<0.01), respectively. Risk of onset for illnesses significantly increased with yearly aging except for cancer. - For comparison between monthly income after adjusting confounding factors(gender, age, income, marriage, occupation, education), with less than 1 million won (1) as the standard, OR(confidence interval) of cancer for 1 to 2 million won, 2 to 3 million won, and more than 3 million won were 0.23(0.03${\sim}$2.16), 2.53(0.41${\sim}$15.43), and 1.73(0.15${\sim}$19.50), respectively. OR(confidence interval) of hypertension were 1.12(0.76 ${\sim}$1.66), 0.68(0.34${\sim}$1.34), and 2.04(1.08${\sim}$3.86, P<0.01), respectively. OR(confidence interval) of stroke were 0.96(0.30${\sim}$3.08) for 1 to 2 million won, and 0.80(0.08${\sim}$8.46) for 2 to 3 million won. OR(confidence interval) of diabetes were 0.73(0.38${\sim}$1.38), 0.65(0.24${\sim}$1.71), and 0.69(0.24${\sim}$2.01), respectively. The values were 0.76(0.55${\sim}$1.03), 1.14(0.75${\sim}$1.73), and 0.90(0.56${\sim}$1.46), respectively for arthritis. OR(confidence interval) of cardiac disorders were 1.15(0.53${\sim}$2.48), 0.63(0.13${\sim}$3.12), and 1.20(0.28${\sim}$5.14), respectively. Risks of cancer, hypertension, stroke, diabetes, arthritis, and cardiac disorders were dependent of monthly income, and stroke and diabetes decreased with increase in income. Summarizing above data, arthritis was significantly higher in women and increase in age by each year brought significant increase in the chance of onset in hypertension, stroke, diabetes, arthritis, and cardiac disorders except for cancer. Stroke and diabetes decreased with increase in income. Above findings can be applied and reflected in public health policies at the national level, and it can also be applied at the personal level for individual health maintenance and prevention.

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