• Health Policy and Management
• /
• v.19 no.3
• /
• pp.109-124
• /
• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.

• Journal of Preventive Medicine and Public Health
• /
• v.45 no.3
• /
• pp.148-155
• /
• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• Journal of Environmental Impact Assessment
• /
• v.1 no.1
• /
• pp.31-40
• /
• 1992

As the environmental concerns in Korea have shifted gradually from the environmental pollutions to the quality of life (QOL) enhancement, it has become increasingly important to implement comprehensive assessment of environmental quality as possible. This is the major reason to develop Environmental Assessment Index. This study focuses on indices development of factors in Environmental Impact Statement Preparation Regulation. Environment in this regulation is composed of natural environment, life environment and socio-economic environment, and it is composed of 22 factors. EAI(Environmental Assessment Index)studied in this research is integrated by 16 factors. It will contribute to public participation in Environmental Impact Assessment process and environmental policy.

• Journal of Environmental Impact Assessment
• /
• v.2 no.2
• /
• pp.95-103
• /
• 1993

EIA has been introduced as a tool for environment protection into promulgation of the Environment Preservation Act in 1977, which replaced the Pollution Control Act in Korea. EIA system has been improved with the enlargement of project type, public participation, guideline improvement, and regulatory development. Recently, Environmental Impact Assessment(EIA) Act will have an important role for sustainable development. This article deals with regulatory development, implementation order, EIA project type, and EIS preparation guidelines by Act promulgated and amended, also it explains comparison analysis of Environmental Policy Act and Environment Impact Assessment Act Major results are summarized in the table.

• Journal of Chest Surgery
• /
• v.49 no.sup1
• /
• pp.20-27
• /
• 2016

Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

• The Journal of Health Technology Assessment
• /
• v.6 no.2
• /
• pp.81-87
• /
• 2018

With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

• Journal of Environmental Impact Assessment
• /
• v.5 no.1
• /
• pp.87-94
• /
• 1996

• Health Policy and Management
• /
• v.28 no.3
• /
• pp.263-271
• /
• 2018

Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

• 대한예방의학회:학술대회논문집
• /
• 1994.02a
• /
• pp.405-411
• /
• 1994

Hazardous wastes released into the general environment are of concern to the public and to public health authorities. In response to this concern, the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (commonly called Superfund), was enacted in 1980 to provide a framework for environmental, public health, and legal actions concerning uncontrolled releases of hazardous substances. The Agency for Toxic Substances and Disease Registry (ATSDR) was created by Superfund to address the public health issues of hazardous wastes in the community environment. Two key Agency programs, Public Health Assessments and Toxicological Profiles, are designed to assess the risk to human health of exposures to hazardous substances that migrate from waste sites or through emergency releases (e.g., chemical spills). The Agency's public health assessment is a structured process that permits ATSDR to identify which waste sites or other point sources require traditional public health actions (e.g.. human exposure studies, health studies, registries, health surveillance, health advisories). The ATSDR qualitative public health assessment complements the U.S. Environmental Protection Agency's quantitative risk assessment. For Superfund purposes, both assessments are sitespecific. ATSDR's toxicological profiles are prepared for priority hazardous substances found most frequently at Superfund sites. Each profile presents the current toxicologic and human health effects information about the substance being profiled. Each profile also contains Minimal Risk Levels (MRLs), a type of risk assessment value. This paper covers ATSDR's experience in conducting public health assessments and developing MRLs, and it relates this experience to recommendations on how to improve chemical risk assessments.

• Journal of Environmental Impact Assessment
• /
• v.4 no.1
• /
• pp.1-8
• /
• 1995

Environmental Impact Assessment(EIA) in Korea has developed as a tool for environmental conservation and decision making since Environmental Impact Statement(EIS) preparation in 1981. For effective implementation of it, we do system development and method enhancement continuously. The recently introduced GIS (Geographic Information System) can integrate geographic and attribute data, which will be applied to scoping, assessment, and alternative assessment, etc. in EIA. This study has three major components. First, it explains building of EIA factors of natural environment, living environment, and socio-economic environment of the study area defined in EIS preparation regulation. Second, the study presents applications of assessment method concerning suitability analysis of landfill site using GIS. Finally, it shows integration of GIS and odor impact assessment. Based on these analysis, the study makes some recommendations and conclusions.