Japan has remained a welfare laggard among advanced industrial democracies. Therefore, the introduction of the public long-term care insurance(koteki kaigo hoken in Japanese) in April of 2000 looks very unique in terms of the Japanese social security tradition, because it can be interpreted as the expansion of social security system and the weakening of the market power over the livelihood of the ordinary people. In the era of globalization, in which even the highly developed welfare states are forced to shrink their social security systems, Japan, a welfare laggard, looks like being headed to the opposite direction. This article aims to define the character of the public long-term care insurance, and thereby, to evaluate the recent social policy of the Japanese government. This study follows the social democratic model in the study of the welfare state development, which assumes that, under the condition of a weak social democratic party and a fragmented labor movement, the introduction of the long-term care insurance is not equal to the improvement of the Japanese social security system. The main argument of this article is that the long-term care insurance, notwithstanding its appearance as an expansion of public sphere, is part of market-oriented neo-liberal social reforms, which have remained the main feature of the Japanese social policies since the mid-1970's. For this, this study will do a longitudinal analysis on the social consequences of the long-term care insurance incurred to the Japanese social security system for the long-term care, focusing on the income redistribution, the marketization of long-term care sector and the changes in the financial burden of the government, social insurers and general citizens.
The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.
This study has examined how the welfare system has changed as it has passed through the most controversial period in Korean modern history. The welfare system has changed in a way that adapts to the need for export-led economic growth. Industrialization centered on light industry, which started in the mid-1960s, absorbed the labor force that existed in the rural areas and commodified them, thereby creating a momentum for Korean society to get out of poverty. However, the public de-commodification, ie social security system, adapted to the commodification of the labor force has been institutionalized only in a very limited area and people. Indeed, the de-commodification system was confined to the area directly linked to the reproduction of the labor force. Even so, the target was very limited in the abundance of labor in rural areas. Compulsory medical insurance was rejected because of corporate burden, and industrial accidents insurance was introduced centering on large-scale workplaces. As the Korean economy began to move from the light industry to the heavy industry in the 1970s, the commodificated labor force changed from a low skilled labor force to a skilled male labor force. It is at this time that dual structures have begun to be created between workers employed in export-oriented large enterprises and workers employed in domestic-oriented SMEs. Therefore, the system of de-commodification that supports the reproduction of labor power in response to social risks has also been institutionalized centering on large-scale workplaces.
Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.
Hyeon-Jeong Kim;Ki-Bong Yoo;Young-Joo Won;Han-Sol Jang;Kwang-Soo Lee
Health Policy and Management
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v.34
no.2
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pp.178-184
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2024
Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.
The Serial Securities and the Social Welfare, as the national policy aimed at securing generals' lives, are the policies or systems for the stabilization in lift; especially of law-incomers and workers, for which the povernment has to establish the Social Security System. No wonder the Social Insurance System is a part of the Social Security System and the most important. The Social Insurance System, along with Public Assistance, is underlying the Social Security System. Social Security System includes medical insurance, industrial accident Compensation insurance, national pention insurance and employment insurance. The study is on 'The Oriental Medical Insurance and the Industrial Accident Compensation in the Social Security System' . The rate of industrial accident in Korea marks the highest rank in the world. for laborer, industrial accident do not merely mean the loss of health but the question of the right to live in terms of their loss of opportunity of life. The industrial accident compensation system should be established as the es post facto remedy system to guarantee the injured worker and his/her family's life. The oriental medical insurance system which began to operate in 1987 in Korea is based on unionism and divided into 3 parts; one part for the worker, a second part for the community inhabitants, and a third part for the public service personnel and private school personnel. Today the medical problem must be the most important social assignment to be considered. The medical system of contemporary industrial society has began greatly stood out in relief as a part of social welfare not emphasized on gainings of physicians. Accordingly systematization of the oriental medical insurance was strongly Pursued and it was developed to to the extent of entire nation insurance. Though the history of it is very short, most of the people are getting benefit from the insurance system by the social security system method. This study develops the Oriental Medical Insurance, the Workmen's Accident Compensation Insurance, the Pension System in relation to the industrial accident compensation of Employees, along with the ideas and principles of social insurance.
For the last several months, abortion debates have sparkled in Korea. The government has escalated the need of active punishment of illegal abortions to solve low fertility problems, while some obstetricians and gynecologist have proclaimed stoppage of illegal abortions suing colleague doctors who has conducted illegal abortions. Women's rights groups and researchers have also responded to the abortion debate claiming that women's decisions over their pregnancy are important in making of abortion policies. To contribute to Korean abortion debates, his paper aims to analyze European experiences of abortion polices in relation to the consequences on women's health. For the analysis of European abortion experiences, three countries - Ireland, U.K, and Netherland -are chosen. These three countries are selected since their legal and social acceptance of abortion and the level of safe abortion system are different. Each country is reviewed by national abortion policy, legal regulation, medical system and the role of civil society. The analysis shows several implications for abortion debates occurring in Korea. Various systematic policy mechanisms - abortion on women' request, abortions without complicated doctor's referrals, transparent and anonymous counseling and information provision regarding abortion, training and education for medical professionals to guarantee high quality abortion, abortions funded publicly for women to improve their access to abortions, steady monitoring and auditing abortion procedures and outcomes for safe abortion and so on - are required in Korean society. Two track procedures - safe abortion on women's request and prevention of unwanted pregnancy - are needed for reproduction of healthy women and society.
The purpose of this study is to analyze the human rights found in the North Korean Constitution and their core problem by focusing on elements of human rights suggested by Daesoon Jinrihoe's doctrine of Haewon-sangsaeng (解冤相生 the Resolution of Grievances for Mutual Beneficence). Haewon-sangsaeng is seemingly the only natural law that could resolve human resentment lingering from the Mutual Contention of the Former World while leading humans work for the betterment of one another. Haewon-sangsaeng, as a natural law, includes the right to life, the right to autonomous decision-making, and duty to act according to human dignity (physical freedom, the freedom of conscience, freedom of religion, freedom of speech, freedom of press, etc.), the right to equal treatment in one's social environment, and the right to ensure the highest level of health through treatment. The North Korean Constitution does not have a character as an institutional device to guarantee natural human rights, the fundamental principle of the Constitution, and stipulates the right of revolutionary warriors to defend dictators and dictatorships. The right to life is specified so that an individual's life belongs to the life of the group according to their socio-political theory of life. Rights to freedom are stipulated to prioritize group interests over individual interests in accordance with the principle of collectivism. The right to equality and the right to health justify discrimination through class discrimination. The right to life provided to North Koreans is not guaranteed due to the death penalty system found within the North Korean Criminal Code and the Criminal Code Supplementary Provisions. The North Korean regime deprives North Koreans of their right to die with dignity through public executions. The North Korean regime places due process under the direction of the Korea Worker's Party, recognizes religion as superstition or opium, and the Korea Worker's Party acknowledge the freedoms of bodily autonomy, religion, media, or press. North Koreans are classified according to their status, and their rights to equality are not guaranteed because they are forced to live a pre-modern lifestyle according to the patriarchal order. In addition, health rights are not guaranteed due biased availability selection and accessibility in the medical field as well as the frequent shortages of free treatments.
Kim, Sang Hyun;Choi, Hyun Suk;Kim, Hyang Suk;Shin, Wan Gyoon;Shon, In Ja;Cho, Nam Chun;Choi, Kang Won
Quality Improvement in Health Care
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v.1
no.1
/
pp.44-54
/
1994
A drug use evaluation (DUE) program has been defined as an "authorized a quality assurance process designed to ensure that drugs are used appropriately, safely, and effectively". A retrospective DUE study on ceftazidime has been conducted by reviewing patients charts following criteria for drug use evaluation established by Am.S.Hosp.Pharm. Total 60 charts of patient treated with ceftazidime in Seoul National University Hospital from Jan. 1.1993 to July.31.1993 were retrospectively reviewed. As a result, 44 cases(73%) were met with the criteria for the justification of use. In analysing process indicators including culture and sensitivity test, CBC, LFT, history of anaphylaxis monitoring before initial dose, vital sign monitoring were relatively well documented showing the accepted level above 80%, while appropriated dose were infrequently documented with low accepted level. In outcome analysis, blood culture after discontinuing drug were rarely documented, with accepted level of 46%. For using effectively and safely, ceftazidime is recommended to be administrated to optimal indication, and monitored actively for preventing adverse effect.
The study was conducted to identify the perception of patient-safety and the level of safety care activity among nurses in small-medium sized general hospitals. Data were collected at three hospitals among 344 nurses on April 2012 and administered questionnaire regarding the perception of patient-safety and safety-care-activity. Data analyzed by using descriptive statistics, inferential statistics was used to determine comparison, correlation and association (Pearson correlation, t-test, ANOVA, Scheffe test, multiple regression). The results revealed that there were significant differences in the level of perception of patient-safety according to the nurses' career, time of work, and work department in their hospitals. And also there were significant differences in the level of safety-care-activity according to the nurses' age, position, marriage, the nurses' career, time of work in their hospitals. Nurses with higher perceived level of patient-safety performed more safety-care-activities. The findings of the study suggests that in order to improve the nurse's perceived level of patient-safety and safety-careactivities, the hospitals need to establish the policies that support patient-safety, improvement the environmental system, proper working atmosphere to ensure appropriate work time, regulation nurse-patient ratio are also required.
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