• Health Policy and Management
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• v.30 no.2
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• pp.164-177
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• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• Korea Journal of Hospital Management
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• v.13 no.2
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• pp.20-35
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• 2008

Though the attending system was first implemented in 2003 to facilitate the efficient utilization of medical resources and specialties, only a few hospitals and physicians are participated in that system. The purpose of this study was to investigate the actual facts which related to operation of attending system and propose a basic information to revitalized of the attending system in Korea. The data were collected between August 1 and October 30, 2005 from 25 hospitals and 42 attending physicians who were in part of the attending system. Medical institutions were unwilling to participate despite the advantages of the attending system with respect to the utilization of medical resources and improvement in the quality of medical services. The primary reason for this was the lack of understanding among physicians about the attending system and the difficulty(lack of time) encountered by the attending physicians in administering care to patients hospitalized in the attending hospitals. Moreover insufficient reimbursement for rendered medical services constituted another important reason. In conclusion, we can state that the establishment of a committee is required to discuss the issues surrounding the attending system and to control the growing disparity between the viewpoints of hospitals and physicians. Regardless, there is a need to develop economical incentives for medical institutes. The attending system served as a useful policy in promoting the medical service system and bringing about an improvement in the management of medical institutes.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.70
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• pp.1-20
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• 2016

This study is to find the accurate interpretations for the UCP600 by integrating, ISBP745, Official Opinions of ICC Banking Commission and some Case Laws suggesting the reasonable implication for the upcoming UCP. Major results analyzed by this study are as follows. First, The preclusion rule, UCP600 Article 16(c), is closely connected with the doctrine of documentary cure, so the banks requirement of Single Notice must state all the discrepancies of the documents presented. Exceptionally if the cured documents by the presenter are happened to be inconsistent the initial notice the bank can require the presenter to re-tender within the expiry date or the last day for presentation. Secondly, The Issuing Bank can utilize the right of seeking a waiver of documentary discrepancies from the applicant with the time limit of 5 banking days. If the bank wants to require an applicant to report discrepancies promptly, he may include a provision in the reimbursement engagement limiting the time limit within which the applicant must give notice of facial discrepancies. Thirdly, if a credit contains a non-documentary condition, banks will deem such condition as not states and will disregard it. According to the principle of private autonony if a credit contains a non-documentary condition to be consistent with by the parties concerned in a credit the non-documentary condition can be treated, as an effective condition itself. Fourthly, according to the Korean Supreme Court's decision, negotiation includes the method of crediting the credit amount and then transfers such funds into a special account and controls the account. Finally, UCP600 Article 33 states a bank has no obligation to accept a presentation outside of its banking hours. However, there is no rule in UCP600 in regard to a presentation after the close of business. Hopefully the upcoming UCP has to stipulates a sort of definite article to determine such ambiguous.

• Journal of Digital Convergence
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• v.12 no.5
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• pp.79-87
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• 2014

In general, at the relationship between claim and obligation if debtor does not fulfill its obligations arbitrarily the creditor can claim to debtor such as lawsuit. It means, despite the debtor ordered payment through the judgment, if debtor disobey that judgment, compulsory execution can be performed by the force of the country. In the end, fulfillment of obligation is enforced by national authorities in principle. However, exceptionally, even it established as a valid debt, if debtors fulfill themselves, they may not be protected from the national authorities. That is the natural obligation. The natural obligation originated from the Roman law which enforces strict type legal system and it is exceptional phenomenon in modern civil law which is made up as that all the bonds are likely to recourse. Therefore, in Korean theory acknowledge that debt is natural obligation and there is no exception. However, there are still controversy about the presence and occurrence of natural obligation. So, in this paper, want to review about its extent and effect including the concept of natural obligation.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.2
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• pp.225-232
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• 2006

Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

• Journal of Gifted/Talented Education
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• v.25 no.6
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• pp.971-987
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• 2015

This paper aims at analyzing SW club acitivities on the science core high school using information disclosure. Targeting 103 schools across the nation science core high schools, the factors influencing the SW Club was analyzed. And science core high school education plans, business plans and management reports were analyzed in SW club activities. It was the most influencing on the SW club in Creative-Experiential activities organization of computer courses. So computer curriculum reform is urgently needed. SW extra subject activities and funding was having a positive effect. Tuition reimbursement rates was having a negative effect. But academic achievement did not significantly affect. Therefore as many students as possible should be able to assist the SW extra subject activities. And it is required Programs and budget support that reflect the characteristics of local and school. Also, as science core high schools have STEAM education, science, mathematics and technology home economics teachers etc were leading the SW club activities by fusing the their curriculum and SW education. As these activities are consistent with the purpose of SW education, research should be more active autonomic consisting of various teachers.

• Journal of Preventive Medicine and Public Health
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• v.44 no.4
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• pp.141-148
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• 2011

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

• Korean Journal of Clinical Pharmacy
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• v.12 no.2
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• pp.85-90
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• 2002

The aim of this study was to examine the current turnover status of hospital pharmacists and to analyze the factors which affected the turnover of them after the separation of prescribing and dispensing practice. We surveyed 19 managers of hospital pharmacies and 154 hospital pharmacists. Results are as follows. Pharmacist manpower of hospital pharmacies was only $63.99\%$ in tertiary hospitals and $76.78\%$ in general hospitals respectively of the number of pharmacists before the separation of prescription and dispensing practice. The ratio of those who left hospital pharmacies during the period of January 2000 and October 2001 was $80.23\%$ for tertiary hospitals, and $100.84\%$ for general hospitals. Decrease in the number of pharmacists brought the increase of work load and night duty. Major factors which affected the turnover of hospital pharmacists were found as following: income gap between hospital pharmacists and community pharmacists, increasing workload especially at night and on holidays, infrequent chance for the promotion, and low chance to provide clinical pharmacy services after the separation of prescribing and dispensing practice. Adequate manpower is the basic factor for providing hospital pharmacy services and improving clinical pharmacy services. The study suggested that proper number of hospital pharmacists is to be ensured through strengthening the legal requirement for the hospital pharmacists and improving health insurance reimbursement rate for the pharmaceutical services at hospital.

• Research in Community and Public Health Nursing
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• v.29 no.2
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• pp.244-256
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• 2018

Purpose: This study tried to understand discourses of life-sustaining treatments in general daily and healthcare newspapers. Methods: A text-network analysis was conducted using the NetMiner program. Firstly, 572 articles from 11 daily newspapers and 258 articles from 8 healthcare newspapers were collected, which were published from August 2013 to October 2016. Secondly, keywords (semantic morphemes) were extracted from the articles and rearranged by removing stop-words, refining similar words, excluding non-relevant words, and defining meaningful phrases. Finally, co-occurrence matrices of the keywords with a frequency of 30 times or higher were developed and statistical measures-indices of degree and betweenness centrality, ego-networks, and clustering-were obtained. Results: In the general daily and healthcare newspapers, the top eight core keywords were common: "patients," "death," "LST (life-sustaining treatments)," "hospice palliative care," "hospitals," "family," "opinion," and "withdrawal." There were also common subtopics shared by the general daily and healthcare newspapers: withdrawal of LST, hospice palliative care, National Bioethics Review Committee, and self-determination and proxy decision of patients and family. Additionally, the general daily newspapers included diverse social interest or events like well-dying, euthanasia, and the death of farmer Baek Nam-ki, whereas the healthcare newspapers discussed problems of the relevant laws, and insufficient infrastructure and low reimbursement for hospice-palliative care. Conclusion: The discourse that withdrawal of futile LST should be allowed according to the patient's will was consistent in the newspapers. Given that newspaper articles influence knowledge and attitudes of the public, RNs are recommended to participate actively in public communication on LST.