• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.25-43
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• 2019

This study analyzed the problem of the time difference of medicine price cut in Korea according to the administrative and judicial process and sought to present the amendment in the related law to achieve substantial fairness. We considered unfairness of medicine price cut caused by the administrative and judicial process in three situations, the approval-patent linkage system, realistic differences in the practice of administration and suspension of price cut execution. Based on it, we reasoned out the solution to get substantial fairness in the administrative and judicial process of medicine price cut in Korea. Although each step of the administrative and judicial process is lawful and reasonable, the time difference of medicine price cut according to the administrative and judicial process can result in damages or windfall to both of pharmaceutical company and National Health Insurance Service. In the present legal system of Korea, it is unable to be correct. Thus, we present the amendment to correct the damages and windfall when it happens.

• Journal of the Korean hospital association
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• v.33 no.5 s.291
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• pp.49-58
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• 2004

• 한국사회복지학회:학술대회논문집
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• 2005.10a
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• pp.343-349
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• 2005

• 방재와보험
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• s.113
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• pp.70-71
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• 2006

언제부터인가 우리는 도시 공해와 더불어 결코 유쾌하지만은 않은 바다 건너온 손님들에 의해 건강을 위협받고 있다. 바로 중국, 내몽골 지역의 사막화로 인해 겨우내 얼어 붙었던 흙이 봄바람을 만나 생기는 황사가 그 주범이다. 비록 황사가 토지의 산성화를 막아 농작물이 잘 자라는 데 도움을 준다는 말도 있지만, 요재 불어오는 황사는 중국의 산업화에 힘입어 공해물질을 다량 함유한 먼지이기에 더욱 그 피해가 심각하다. 대표적으로 인체의 호흡기에 침입하여 여러 문제를 일으키고 눈이나 피부에도 질환을 일으킬 수 있다. 즉 황사는 눈을 직접 자극하여 결막염의 증세를 일으킬 뿐만 아니라, 함유된 여러 중금속과 같은 물질들에 의해 알레르기성 질환도 유발할 수 있다는 뜻이다.

• 방재와보험
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• s.118
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• pp.72-73
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• 2007

현대를 살아가는 사람들에게 있어 직장에서의 과중한 어부와 성공을 위한 치열한 경쟁, 복잡한 인간관계, 그 속에서 발생되는 과로 및 정신적 스트레스는 심각한 건강상의 문제점을 야기할 수 있다. 과거에는 과로로 인한 건강상의 문제들이 전적으로 개인의 건강관리 문제로 방치되고 보상의 대상이 되지 못했다. 소위 과로사가 우리나라에서 인정받기 시작한 것도 1990년대 이후 국민들의 권리의식 신장과 외국의 사례보도 등에 의해 소송이 시작되면서부터였고, 그 인정범위는 점차 확대되어 가고 있다.

• Proceedings of The Korean Society of Health Promotion Conference
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• 1998.07a
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• pp.81-97
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• 1998

국민들의 생활수준향상 및 질병양상의 변화 등으로 건강에 대한 관심이 증대됨에 따라 지역사회 뿐만 아니라 의료보험관리공단 및 의료보험조합에서도 각종 만성퇴행성질환에 대한 사전예방을 통하여 국민의 건강증진을 꾀하고 삶의 질을 향상시킴으로써 의료비 지출을 절감시킬 수 있는 보건예방사업을 전개하기 시작하였다. 이는 예방이 치료보다 10배 정도의 비용절감효과를 가져오기 때문이다.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.3
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• pp.285-299
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• 2022

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into 'general background of the respondents', 'the awareness on national health insurance (NHI) and DHI', 'the awareness on DHI pertaining to pediatric dentistry', 'issues that need improvement on DHI pertaining to pediatric dentistry', 'DHI claims', and 'the roles of KAPD in DHI'. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.

• 한국노년학
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• v.32 no.2
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• pp.593-609
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• 2012

The study was performed to identify the functional status change of beneficiaries of Long-Term Care Insurance and its related factors. We conducted the logistic regression with 17,652 beneficiaries during August and September in 2008. As a result, activities of daily living(ADL), behavioral changes, rehab, instrumental activities of daily living(IADL) and cognitive function, followed by nursing care area were improved in a greater degree. For the institutional service, level-1 beneficiaries was significantly improved in rehab area and level-2 beneficiaries was improved in ADL. For the home-visit care service of in-home services, level-1 beneficiaries was improved in ADL, level-2 beneficiaries was improved in ADL and rehab area, level-3 beneficiaries was improved in ADL, cognitive function and behavioral changes. For the day-and-night care service, level-1 beneficiaries was improved in ADL, IADL, behavioral changes and rehab area, level-2 beneficiaries was improved in behavioral changes, level-3 beneficiaries was improved in cognitive function and behavioral changes. For the short-stay service, level-3 beneficiaries was improved in behavioral changes. By the above results, there was a difference in a functional improvement by level and used services. Therefore, government need to provide the personalized service system based on the objective and comprehensive understanding for health and functional status of beneficiaries.

• Journal of Convergence for Information Technology
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• v.9 no.9
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• pp.195-200
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• 2019

The purpose of this study is to analyze the characteristics of National Health Insurance claim data and to construct a pilot medical episode data considering it. In this study, the trends of respiratory disease (ICD10: J00-J99) cardiovascular disease (ICD10: I00-I99) from the day of onset of treatment to re-admission after admission were confirmed in Seoul, and the largest decrease was observed when the no-treatment period was 0 day. The data reduction rate when the no-treatment period is 0 day is judged to be due to the monthly separation claim of the health insurance claim data. Also, the result that there is a tendency of monthly separation request according to the type of medical treatment. Through this study, we constructed epidemic data for the pilot medical treatment considering the characteristics of the claim data of health insurance, and based on this, it can be used as a data processing method for calculating basic epidemiological information.

• 건강소식
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• v.13 no.1 s.122
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• pp.38-45
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• 1989

현재 의료보험은 치료에 국한된 요양급여가 대부분인데, 예방사업을 통한 질병발생의 예방이 건강의 손상을 줄이고 궁극적으로는 건강을 증진시킬 수 있으며 의료비의 상승을 억제할 수 있다고 안윤옥 서울의대 교수는 지난해 11월11일에 있었던 건강관리 워크숍에서 강조했다. 본문은 안교수의 발표문을 게재한 것이다.