• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.3-36
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• 2022

In order to solve the pharmaceutical kickback problem, it is needed to establish legal system that allow ways to enable pharmaceutical promotion of medicines without kickbacks as well as provide sanction those who commit illegal act. Before the National Assembly and the government focused on strengthening sanctions. As a result, in 2014, a system of suspending medical care benefits was introduced, which could inflict heavy losses on pharmaceutical companies by withdrawing target medicines from the market. However, three years after the introduction, the system was abolished in 2018, recognizing the problem that the disposition could infringe on the patients' right to access to and choice of medicines. In 2021, the National Assembly made it possible for dispositions suspending medical care benefits regarding the third violation, which remained symbolic until then, replaced with administrative fines. Although the legislator's reflective stance on the system is more than clear, the Ministry of Health and Welfare still interprets that the old law should be applied to kickbacks for the period of the law. Moreover, regarding the substitution of fines at the discretion of the Minister of Health and Welfare under the old law, the narrow standards taken under the old law seems to be maintained. In this paper, firstly pharmaceutical kickback issue, the main reason for the introduction of the system, will be explained, after that the history of introduction and abolition of the system examined and last but not least the unconstitutionality of the system and the illegality of the disposition are to be examined.

• Journal of Korean society of Dental Hygiene
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• v.18 no.2
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• pp.177-189
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• 2018

Objectives: To provide necessary information for stable establishment of the national dental scaling reimbursement system. Methods: This study was conducted in 380 adults in their twenties or older for about one month from July 2017. The questionnaires were composed of general characteristics, recognition (awareness) of dental scaling, knowledge of the dental scaling reimbursement program, changes in perception before versus after introduction of the dental scaling reimbursement program, and interest in oral health. To investigate into any factors affecting changes of interest in oral health care after introduction of the dental scaling reimbursement program, a multiple regression analysis was performed. Results: The investigation into any factors affecting changes of interest in oral health care after introduction of the dental scaling reimbursement program showed that higher usual interest in oral health (p<0.001) and the consideration that the dental scaling charges have been affordable after introduction of the scaling reimbursement program (p<0.01) led to more changes in interest in oral health care. Conclusions: The above-mentioned results suggest that the dental scaling reimbursement program has brought favorable changes in the perception of dental scaling. It is expected that the said program will contribute significantly to the improved national oral health, and the Government should make constant efforts to develop it as a long-term policy for oral health improvement.

• Health Policy and Management
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• v.31 no.3
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• pp.344-354
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• 2021

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

• The Journal of the Korea Contents Association
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• v.15 no.11
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• pp.126-136
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• 2015

The purpose of this study is to analysis the effect of positive psychological capital on turnover intention of care worker in Long-term Care Program. Main results are as follows. First, the results identified the characteristics of the sub-factors of positive psychological capital, The efficacy, hope and resilience of care workers mostly are higher as the more married man, the longer working hours, the longer the career, the more good health condition, the more religion and more the salary. Second, total positive psychological capital is higher as the longer working hours, the more good health condition and the more the salary like sub-factors' characteristics of positive psychological capital in care workers. Third, the turnover of care worker also is higher as the longer working hours and the shorter professional career and the more unmarried. Finally, the positive psychological capital was having a negatively significant impact on turnover intention. In other words, turnover intention of the care worker is lower as the higher positive psychological capital.

• Journal of dental hygiene science
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• v.17 no.2
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• pp.87-98
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• 2017

The purpose of this study was to understand the effectiveness of oral health education (OHE) or oral hygiene instruction (OHI) involving professional plaque control/removal, as compared to conventional plaque control/removal. By means of a systematic review of the literature, in the review of literature by using systematic method, Korean articles of plaque control including OHE or OHI, were studied in order to analyze and conclude the literature to enhance oral health. We found that self and professional plaque control/removal, in addition to tooth brushing instructions, decreased incidence and prevalence of loss of teeth. Taken together, professional mechanical plaque removals were most effective 4~5 visits every 1~2 weeks. Use of disclosing agent was more effective than oral education or model education. In line with oral hygiene education, professional brushing, oral prophylaxis, scaling and root planing, it was advisable to repeat the training according to the characteristics of the patient. Routine OHE or OHI would be help to increase to oral health. For a quality of life related oral health, reliability and validity of data are needed to develop and its data should be applied to dental health insurance policy.

• Journal of Legislation Research
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• no.44
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• pp.689-723
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• 2013

Suicide is Korea's first leading cause of death in their twenties and thirties. at a rate of 31.2 per 100,000 in 2010. The Korea suicide rate is over twice higher than OECD's average rate. Because of this reality the suicide prevention act(full title, the Act on Prevention of Suicide and Creation of Culture that Respects Life) was enacted in 2011. In 2008, the Korean government planned the suicide prevention programs to decrease the incidence of suicide to approximately 20 per 100,000 by the end of 2013. Despite the plan the suicide rate in Korea has increased to over 30 per 100,000 since 2009 and the plan was proved to be failed. Consequently, the government was unable to lower the suicide rate in last decade. It has shown that the reduction of suicide rate is a difficult and complex problem. This study shows that the root cause of suicide is based on social and legal exclusion and proposes that suicide prevention measures should be aimed at social cohesion and legal protection.

• Journal of agricultural medicine and community health
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• v.35 no.1
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• pp.77-88
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• 2010

Objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with hypertension, diabetes and dyslipidemia using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. Methods: The medical expenditure of hypertension, diabetes and dyslipidemia related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. Results: The medical expenditure attributable to overweight and obesity of hypertension were 456 billion won (men : 215 billion won, women : 241 billion won). Those of diabetes were 282 billion won (men : 148 billion won, women : 135 billion won), and of dyslipidemia were 17 billion won (men : 9 billion won, women : 8 billion won). Consequently, these costs corresponded to 33.3% of total medical expenditure due to hypertension, diabetes and dyslipidemia. Conclusions: We found a substantial medical expenditure due to overweight and obesity of hypertension, diabetes and dyslipidemia were very high. In order to reduce these costs, effective national strategies for prevention and management of overweight and obesity should be established and implemented.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2674-2683
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• 2015

This study was performed to determine the levels of depression(CES-D) and its related factors among the elderly people affiliated with long-term care insurance services in urban areas. The interviews were performed, during the period from March 1st, to May 31th, 2012, to 388 elderlies. As a result, the levels of depression among all subjects were 21.6% of normal group, and 78.4% of depression group. The distribution of depression according to the grade of long-term care insurance were 83.6% in Grade I, 82.1% in Grade II and 67.0% in Grade III, and the level of distribution were significantly higher according to the higher grade of long-term care insurance. For the results of multiple logistic regression analysis, the odds ratio was increased in older age group, in the poor health status group, and in the group of seldom in activity of hobbies than their counterparts, but it was decreased in the higher monthly income group than lower group. Above results suggested that the depression was significantly related with the variables such as sociodemographic characteristics, economic status, health related factors and health status.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.76-89
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• 2018

The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.