• Title/Summary/Keyword: 의료보장

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Legal Issues in Protecting and Utilitizing Medical Data in United States - Focused on HIPAA/HITECH, 21st Century Cures Act, Common Law, Guidance - (미국의 보건의료데이터 보호 및 활용을 위한 주요 법적 쟁점 -미국 HIPAA/HITECH, 21세기 치료법, 공통규칙, 민간 가이드라인을 중심으로-)

  • Kim, Jae Sun
    • The Korean Society of Law and Medicine
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    • v.22 no.4
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    • pp.117-157
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    • 2021
  • This research reviewed the HIPAA/HITECH, 21st Century Cures Act, Common Law, and private Guidances from the perspectives in protecting and utilitizing the medical data, while implications were followed. First, the standards for protection and utilization are relatively clearly regulated through single law on personal medical information in the United States. The HIPAA has been introduced in 1996 as fundamental act on protection of medical data. Medical data was divided into personally identifiable information, non-identifying information, and limited dataset under HIPAA. Regulations on de-identification measures for medical information, objects for deletion of limited data sets, and agreement on prohibition of data re-identification were stipulated. Moreover, in the 21st Century Cures Act regulated mutual compatibility for data sharing, prohibition of data blocking, and strengthening of accessibility of data subjects. Common Law introduced comprehensive consent system and clearly stipulates procedures. Second, the regulatory system is relatively simplified and clearly stipulated in the United States. To be specific, the expert consensus and the safe harbor system were introduced as an anonymity measure for identifiable medical information, which clearly defines the process while increasing trust. Third, the protection of the rights of the data subject is specified, the duty of explanation is specified in detail, while the information right of the consumer (opt-out procedure) for identification information is specified. For instance, the HHS rule and FDA regulations recognize the comprehensive consent system for human research, but the consent procedure, method, and requirements are stipulated through the common rule. Fourth, in the case of the United States, a trust-based system is being used throughout the health and medical data legislation. To be specific, Limited Data Sets are allowed to use in condition to the researcher's agreement to prohibit re-identification, and de-identification or consent process is simplified under the system.

Organisation des Rettungsdienstes in Deutschland (독일의 응급구조업무의 조직)

  • Kim, Ki Young
    • Proceedings of the Korean Society of Disaster Information Conference
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    • 2015.11a
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    • pp.300-302
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    • 2015
  • 독일의 응급구조업무의 조직은 독일 기본법(GG) 제30조, 제70조에 따라 오로지 연방부들에게 있다. 유럽 연합은 기술적 조직적 통일성과는 별도로 각각의 국민들의 건강보호의 일부분으로 응급구조의 조직과 재정에서 상당히 광범위하게 재량을 인정하고 있으며 이에 따라 유럽연합의 시스템과 정책들의 입법적 조화를 사실상 포기하고 있는 실정이다. 독일연방주들은 자신들의 주응급구조법률(LRDG)에서 응급구조업무의 보장을 일반적으로 재차 지방자치단체(주 근교도시중심)에게 독자적인 업무로서 인정하고 있다(가령 슐레비히 홀스타인주 응급구조법(RDGSH) 제6조). 이러한 주들은 응급구조를 자신의 관할지역에 대해 준비하고 스스로 운영하거나 운영통제할 수 있는 구조목적의 단체들(RZV)과 공동협력을 할 수 있다. 각각의 업무능력과 법적인 기준에 따라 구조 목적의 단체들(RZV)은 자신의 이름으로 응급구조를 운영하거나 하나 또는 다수의 기관(공공 구조서비스 혹은 사설 구조서비스)에게 시행을 위임할 수 있다. 이러한 측면에서 본 연구에서는 독일의 경우 의사가 직접 현장 의료를 담당하고 있다는 점에서최근 입법을 통해 응급구조사의 교육과정을 개편하고 있으며, 질적 향상을 통해 응급의사와 응급구조사의 권한범위에서 독일 응급구조사의 권한확대가 시도되고 있다는 시사점을 도출하고 있다.

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The Development Path of China's Private Health Insurance and Its Role in the Health Care System (중국 민간의료보험의 발전경로와 의료보장체계에서의 역할)

  • Jung, Kee Taig;Fan, Jian Cheng;Chen, Wan Yun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.423-436
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    • 2021
  • This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

The Right to a Humane Livelihood and the Right to Health on Korean Constitution (인간다운 생활을 할 권리와 건강권)

  • Park, Jiyong
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.3-24
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    • 2019
  • This research examines the constitutional meaning of the right to health through reviewing the decisions of the Constitutional Court and proposed amendment of the Constitution issued by the President. This article further discusses the relationship between the right to a humane livelihood and the right to health. Health is a fundamental freedom and inalienable human right which is a prerequisite to accomplish individual's independent activity and realization of value. Thus, the government is obligated to protect and uphold the right. Article 36(3) of the Constitution delineates the government's duty to protect and fulfill the right to health. Through the interpretation of both Article 36(3) and Article 34 of the Constitution, I suggest that the right to health implies 'the right to social security for health'. The Constitutional Court has narrowly interpreted the scope of the right to a humane livelihood by defining the term as "minimum material living standards". However, it should be interpreted as 'the right to enjoy a healthy and cultural life for human dignity' and setting the level of protection is solely on the discretion of the legislative branch. Ultimately, the judicial review on the right to a humane livelihood connects with the issue of rational control for legislative discretion.

Factors Affecting the Choice of Medical Care Use by the Poor (저소득층의 의료 이용과 욕구 미충족에 영향을 미치는 요인)

  • Kim, Jin-gu
    • Korean Journal of Social Welfare Studies
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    • no.37
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    • pp.5-33
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    • 2008
  • This study examines the use of medical care by the poor through analysing KNHANES III databases, and the focus of the study is on under-satisfaction of medical needs and the impact of the medicare system. The results of analysis are summerized as follows; the poor had generally suffered from poor health condition, and did not have economic resoure to satisfy the medical needs. But, the beneficiaries of the medicare used much more medical care than non-poor. The result of logistic regression suggest that the medicare affected significantly on increase of uses. Consquently, the medicare system effectively made up the lack of economic resoure of the poor. However, the Medicare did not sufficient to satisfy all the medical needs of the poor. Over 20% of the poor had experinced the abandonment of meical care uses, "the lack of econmic resource" was most important reason. The result of logistic regression suggest that all the poor such as Medicare I and Medicare II beneficiaries, and near-poor class had much more probabilities of giving up the use of medical care than non-poor. It is necessary to raise up the benefit level of the current medicare system such as the reduction of non-secured medical cost, the alleviation of user's burden etc.

A Study of Software Architecture Design Methods for Multiple Access Con trol under Web-based Medical Information System Environment (웹 기반 의료정보시스템 다중 접근제어를 위한 소프트웨어아키텍쳐 설계방법)

  • Noh, Si-Choon;Hwang, Jeong-Hee
    • Convergence Security Journal
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    • v.11 no.4
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    • pp.43-49
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    • 2011
  • Web-based health information provides a lot of conveniences, however the security vulnerabilities that appear in the network environment without the risk of exposure in the use of information are growing. Web-based medical information security issues when accessing only the technology advances, without attempting to seek a safe methodology are to increase the threat element. So it is required. to take advantage of web-based information security measures as a web-based access control security mechanism-based design. This paper is based on software architecture, design, ideas and health information systems were designed based on access control security mechanism. The methodologies are to derive a new design procedure, to design architecture and algorithms that make the mechanism functio n. To accomplish this goal, web-based access control for multiple patient information architecture infrastructures is needed. For this software framework to derive features that make the mechanism was derived based on the structure. The proposed system utilizes medical information, medical information when designing an application user retrieves data in real time, while ensuring integration of encrypted information under the access control algorithms, ensuring the safety management system design.

The Problems and the Improvement Plan of the Hospice/Palliative Care and Dying Patient's Decisions on Life-Sustaining Treatment Act (연명의료결정법의 문제점 및 개선 방안)

  • Kim, Myunghee
    • Journal of Hospice and Palliative Care
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    • v.21 no.1
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    • pp.1-8
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    • 2018
  • Nearly 20 years after the Boramea Hospital case, the act on decisions on life-sustaining treatment for patients in hospice and palliative care or at the end of life has taken effect on February 4, 2018 as recommended by the National Bioethics Committee. However, during the legislation process, some parts of the bill that stakeholders and concerned parties did not see eye to eye were either revised or removed. Moreover, the hospice and palliative care part was added in the last minute before the enactment. As a result, the law includes parts that are not in line with the recommendations from the National Bioethics Committee, thereby causing various problems. Therefore, it is crucial to monitor how the decisions on life-sustaining treatments are made in the field and gather various opinions of concerned parties to identify and address problems in the early stage of the implementation of the law. Based on the data, the legislation must be amended to fulfill its purpose that is "to protect the dignity and value of human beings by assuring the best interests of the patients and by respecting their self-determination".

Differences of Cancer Patient's Health Care Utilizations between Medical Aid Program and National Health Insurance in the Elderly (노인 암환자의 건강보험과 의료급여 이용차이 분석)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.270-279
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    • 2011
  • This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

Estimating social and economic costs for outpatient injuries by using Korea medical panel data (한국의료패널데이타를 이용한 외래 환자 손상의 사회경제적 비용 추계)

  • Choi, Eun-Mi;Yoo, In-Sook
    • Journal of Korea Society of Industrial Information Systems
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    • v.20 no.4
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    • pp.55-65
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    • 2015
  • An increase in patients' medical expenses for their injury. accident and intoxication is a major challenge to improve the sustain-ability of a national health security system, and increasing medical expenses need be suppressed through improving relevant systems and/or efficiently operating and managing the health insurance. At this juncture, in Korea which has a high rate of injury incidence and mortality, it is necessary to estimate social and/or economic costs for injuries with a focus on their social effects. This research has examined the results of a Korea medical panel investigation conducted in 2008, which largely surveyed of the actual conditions of outpatients' medical use for their injury, accident and/or intoxication and investigated relevant medical expenses, with a view to estimating the directly incurred costs when the patients use medical services and the production loss costs caused by an production decline and others, so that social and/or economic costs for injuries may be ultimately aggregated.

The History of Hospice and Palliative Care in Korea (한국 호스피스 완화의료의 역사)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.1-7
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    • 2019
  • The first hospice care center in Korea dates back to the East West Infirmaries (Dongseodaebiwon in the Korean language) of the Goryeo period in the early 11th century. It has been 50 years since hospice care was introduced in Korea. Initially hospice care was provided in the private sector, including those with a religious background, and its development was slow. In the 1990s, related religious organizations and academic associations were established, and then, a full-swing growth phase was ushered in as the Korean government institutionalized hospice care in the early 2000s. As a result, enhanced quality of hospice care service could be provided, which meant better pain management and higher quality of life for late stage cancer patients and their families. Still, the nation lacked a realistic reimbursement system which was needed to for financial stability of the affected patients. However, the national health insurance scheme began to cover hospice palliative expenses in 2015. In 2016, the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life was legislated, allowing terminally-ill patients to refuse meaningless life-sustaining treatments. As the range of diseases subject to hospice palliative care was expanded, more challenges and issues need to be addressed by the service providers.