• Title/Summary/Keyword: oriental medial services

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Cost Sharing System of Oriental Medical Services in the National Health Insurance (한방의료의 건강보험 본인부담 실태분석)

  • Byun, Jin-Seok;Lee, Sun-Dong;Yoo, Wang-Keun;Kim, Jin-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.10 no.2
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    • pp.95-120
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    • 2006
  • The purpose of this paper is to investigate the structure of cost-sharing for oriental medical services in the national health insurance. Out-of-pocket payment in ambulatory oriental medical care is a co-payment of KRW3,000 up to total expenses of KRW15,000, and co-insurance rate of 30% thereafetr. The empirical analysis based on medial claims data shows that the frequency of medical claims for outpatient care are mostly concentrated just below a total expenses of KRW15,000, and it decreases beyond a total expense of KRW15,000, while it rebounds between KRW17,000${\sim}$20,000. This means the current co-payment(KRW3,000) in oriental medical services should be applied up to a total payment of KRW17,000${\sim}$20,000, or the level of co-payment should be adjusted upward to KRW45,000 in order to be consistent in cost-sharing, between co-payment and co-insurance.

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Research on the Rational Solution for Oriental Medical Conflicts - Focusing on the relieving role of KCA in oriental medical disputes - (한방의료분쟁의 합리적인 해결방안 연구 - 한국소비자원의 한방의료 피해구제를 중심으로 -)

  • Jeong, Mi-Young
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.383-422
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    • 2008
  • Considering above, It might be efficient that medical disputes would be settled by the intervention, the agreement, and the administrative relief that reflect mediators' opinion, who have rich social experience as well as specialized knowledge. Therefore, KCA needs to strengthen its function of mediation and improve relevant systems to become an effective settlement institution. And although Oriental medicine disputes have mainly given ex post facto explanations so far, administrative efforts such as policy development or legislation should be made for the high quality of Oriental medical services offered because an efficient way saving social or economic costs caused by the dispute would be precautionary measures. The traditional Oriental medicine is featured with the lack of baseline examination, the uncertainty of medical mistakes, the difficulty in clarifying and proving facts, the hardship of injury conformation and causality because of the characteristics of Oriental medicine, and the relative lightness of physical damages. Actually, there has been few legal settlements in Oriental medical disputes since the compensation, itself, compared to the lawsuit cost, is relatively much lower without practical benefits.

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A study of the Consumer's Satisfaction and the Marketing Strategies of a General Hospital (일 종합병원의 소비자 만족과 마케팅 전략에 관한 연구)

  • Lee, Mi-Aie
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.25-40
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    • 2001
  • As the medical market has gradually changed from supplier-centered market to consumer-centered one, it makes hospital managers seek the consumer's satisfaction and the various marketing strategies for survival. Under the these changes, this study was accomplished to measure the consumer's satisfaction about the medial services which a general hospital provided, to identify the marketing strategies that a general hospital could establish for survival. For these purposes, a questionnaire was developed and distributed to 200 patients in general units and 100 patients in oriental units of a general hospital in Seoul. Among them, 163 reponses in general units and 71 reponses in oriental units were turned out to be useful. they were used for final analysis. The results of the survey were as follows : First, among all items of medical services which the hospital provided, patients were most satisfied by nursing services. Second, to Improve the hospital's medical service quality, it was very important for hospital staffs to be courtesy and to explain about a process of treatment or care sufficiently. Third, to decrease cost of medical service, it was very important to develop the various items and premiums of medical insurance especially in field of oriental medicine. Fourth, to make people come to the hospital easy, it was very important of fully utilize the public transportation such as subway. Fifth, to make hospital's image good, it was very important to develop well-prepared public relationship and to continuously provide the diverse medical service in the community.

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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.