• Title/Summary/Keyword: Health insurance to Korean medicine

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Formation, Development and Task of the Health Insurance Act (건강보험법의 형성과 발전, 그리고 과제)

  • CHEON, Kwang Seok
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.3-45
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    • 2019
  • Health insurance is the main instrument to protect the people against sickness. To examine the task of in the future it would be necessary to extract and understand the components formed in its formation and development, benefit related and normative characteristics of the health insurance itself. The health insurance oriented itself to the universal coverage at a law level. Paradoxically this worked positively for the universal development of the health insurance. The task of the health insurance is on the one hand universal, positive and open. On the other hand it has to shape type of allowed method, art and content of the medical treatments into the regulation to ensure the equal benefit as well as the financial stability. That is, the health insurance should check the aberrant medical treatment, and at the same time should be compensated for the their necessity and effectiveness. However there are always some structural differences between both requirements. This article aims to restate and analyse the development of the health insurance, based on the characteristics formed hitherto show the way to reform the health insurance. The problem to enhance the coverage of health insurance, its institutional as well as financial crisis, its peculiar governance would be handled.

A Study on the Social Medical Approach of Oriental Medical Insurance (한방의료보험의 의료사회학적 접근에 관한 연구)

  • Kim Jeong-Pil;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.2 no.1
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    • pp.113-144
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    • 1998
  • Through the sociological approach on the Oriental Medical Insurance, 1 has reflected on the necessity and propriety of the Herb-pack Medicine Insurance, what the government and the Oriental Medicines as the main organization of it should think about. So I come to the conclusion as follows ; First, medical sociological approach must precede the study on the Herb-pack Medicine Insurance and in the process concrete, political problem must be solved. Second, although the Oriental Medicines has a different way from the Western Medicines, it comes to take up a part of health service field with its independent efforts. And coming changes count on whether the Oriental Medicines exert independently or not. Third, due to the original limit of the Oriental Medical Insurance, it has little effect on the Oriental Medicine Service's popularization and development. Yet bit gives the opportunity to present where the Oriental medicines should go and the way to develop it is the practice of the Herb-pack Medicine Insurance. fourth, so it can be said that the practice of the Herb-pack Medicine Insuranceis our important plan which can not only make the Oriental Medicines improve as the professional jods but also solve the contradiction of the Korea Medicines

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Bilateral Sciatic Neuropathy Following Rhabdomyolysis: A Case Report (횡문근융해증 이후 나타난 양측 좌골신경병: 증례보고)

  • Lee, Sang Yoon;Cha, Jun Min;Kim, Seong Woo;Jeon, Ha Ra
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.139-143
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    • 2018
  • Rhabdomyolysis is a syndrome caused by injury to skeletal muscles and involves leakage of large quantities of potentially toxic intracellular contents into the plasma. It is known that rhabdomyolysis results in peripheral nerve injury, however, reports of bilateral sciatic neuropathy following rhabdomyolysis are rare. We report a case involving a 42-year-old female patient with no past medical history, who presented with sudden bilateral calf pain, redness, and burning sensation with weakness of both lower extremities after sleeping on an electric heating pad following alcohol drinking. Lower extremity magnetic resonance angiography (MRA) revealed multifocal edema with enhancement of bilateral lower extremity muscles. Clinical and electrodiagnostic tests were consistent with the diagnosis of bilateral sciatic neuropathy following rhabdomyolysis. This is a rare case of bilateral sciatic neuropathy following rhabdomyolysis.

Data Analytic Process of a Nationwide Population-Based Study on Obesity Using the National Health Information Database Presented by the National Health Insurance Service 2006-2015

  • Kim, Yang-Hyun;Han, Kyungdo;Son, Jang-Won;Lee, Seong-Su;Oh, Sang Woo;Kwon, Hyuk-Sang;Shin, Soon-Ae;Kim, Yeon-Yong;Lee, Won-Young;Yoo, Soon Jib;Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity
    • Journal of Obesity & Metabolic Syndrome
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    • v.26 no.1
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    • pp.23-27
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    • 2017
  • Background: In Korea, the prevalence of obesity has steadily increased, and the socioeconomic burden of obesity has increased along with it. In 2015, the National Health Insurance Service (NHIS) signed a memorandum of understanding with the Korean Society for the Study of Obesity (KSSO), providing limited open access to its databases so that the status of obesity and obesity management could be investigated. Methods: Using NHIS databases, we analyzed nationwide population-based studies for obesity using the definition of obesity (body mass index ${\geq}25kg/m^2$) in subjects over the age of 20. Age and sex standardization were used for all data. Results: The KSSO released the 'Obesity Fact Sheet 2016' using the 2006-2015 NHIS Health Checkup database. The prevalence of obesity steadily increased from 28.7% in 2006 to 32.4% in 2015, and the prevalence of abdominal obesity also steadily increased from 18.4% in 2009 to 20.8% in 2015. The prevalence of class II obesity steadily increased from 2006 to 2015, such that the total prevalence was 4.8% in 2015 (5.6% in men and 4.0% in women). The highest prevalence of obesity was found in Jeju Island, while the lowest prevalence was found in Daegu City. The highest prevalence of abdominal obesity was also found in Jeju Island, while the lowest prevalence was found in Gwangju City. Conclusion: Based on the Obesity Fact Sheet 2016, a strategy for reducing the prevalence of obesity is needed, especially in Korean men.

Cancer Survival and Status of National Health Insurance in a Community (A일개 군지역 암등록자료의 국민건강보험 보장유무에 따른 암 생존율 차이)

  • Kweon, Sun-Seog;Choi, Jin-Su;Shin, Min-Ho;Kim, Hye-Yeon;Choi, Seong-Woo;Lee, Young-Hoon
    • Health Policy and Management
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    • v.19 no.2
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    • pp.127-134
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    • 2009
  • It is known that socioeconomic status(SES) of the cancer patient is associated with survival in recent studies, performed in other countries. The purpose of this study was to determine whether the association between status of national health insurance and survival is also present in a community in Jeonnam province, South Korea. The Gwangju-Jeonnam Cancer Registry, a population-based cancer registry, provided information to identify the cancer cases of study community diagnosed from 1998 to 2007. Total of 2,046 cases were identified during the period. There were significant associations between the status of national health insurance and survival for total cancer after adjusted by age, geographic accessibility to health care, and stage at diagnosis. However, this differences were not found in the analysis using only stomach and colorectal cancer cases. Despite of some limitations, this results suggest that the policy for reducing the difference according to the SES is required in national cancer management program.

A Comparative Analysis of the Systems Related to the Production, Authorization, and Listing for Insurance of Herbal Medicine Products in South Korea and Taiwan (국내와 대만의 전통약제제 생산.허가.보험등재 관련 제도)

  • Son, Chi-Hyoung;Lim, Sabina;Lee, Eun-Kyoung;Kim, Dong-Su;Kim, Yun-Gi;Cheng, Huan-Chiang;Kim, Yong-Ho
    • The Journal of Korean Medicine
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    • v.33 no.3
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    • pp.147-159
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    • 2012
  • Objectives: Systems related to the production, authorization, and listing for insurance of herbal medicine products were compared between South Korea and Taiwan to illuminate herbal medicine products system issues in South Korea. Methods: Papers, and laws and policies related to the production, authorization, and listing for insurance of herbal medicine products in South Korea and Taiwan are analyzed to create the primary documents. The documents from South Korea were screened with the advice of a specialist, while those from Taiwan have been verified through local investigation and with the help of a related specialist. The screened documents were then compared and analyzed in the order of the systems related to the production, authorization, and listing for insurance of herbal medicine products. Results: The systems related to the production of herbal medicine products satisfy GMP requirements in both countries, while Taiwan has more specialized systems related to the production of herbal medicine products and a more strict authorization program as compared to South Korea. While South Korea has most of the herbal medicine products classified as non-prescription drugs, Taiwan has them as prescription drugs. And while South Korea does not allow new herbal medicine products to be listed for insurance, Taiwan allows for once-a-year application toward listing for insurance. Conclusions: In order to ensure the safe and effective use of herbal medicine products, systems related to the production, authorization, and listing for insurance of herbal medicine products are to be established, while the categorization of medicine products principally used by Korean medicine doctors should be prepared. Furthermore, prescription by a Korean medicine doctor for new drugs made with natural products and their listing for insurance need to be encouraged.

Tasks for the Separation of Prescribing and Dispensing medicinal herbs in Traditional Korean Medicine (한의약분업과 관련된 여러 가지 문제)

  • Lee, Hai-Woong;Kim, Hoon;Kim, Gyeong-Cheol;Kim, Jong-Hwan;Shin, Woo-Jin;Park, Dong-Il;Hwang, Won-Duk
    • Journal of Korean Medical classics
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    • v.23 no.1
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    • pp.133-142
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    • 2010
  • Preconditions for the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine are classification of medicinal herbs for general public and special medical uses, establishment of national medicinal herb distribution company of governmental base, restriction in purchase of medicinal herbs for special medical use, partnership between doctors and pharmacists of Traditional Korean Medicine, and coverage of herbal medicine-based medication in national health insurance, etc. The number of Traditional Korean Medicine Pharmacists which was born during 'the herbal medicine conflict' initiated in 1993, goes over 1,000 and will increase by 120 annually. The number of Traditional Korean Medical Doctors is over 17,000 and increases by 850 annually. So in order to engage partnership between two groups, the government have to arrange the number of outputs of each group. Standardization and classification of diagnosis and diseases in Traditional Korean Medicine is a matter of course in the separation of prescribing and dispensing medicinal herbs. Related societies and academies need to do researches with governmental fund first. After these works, we can launch a task force team for implementation of process for the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine properly. Entering the national health insurance system for full coverage of Korean Medicine care service will be essential for the patients. Implementation the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine would be the core of health insurance coverage for medication.

The Determinants of Purchasing Private Health Insurance in Korean Cancer Patients (암 환자의 민간의료보험 가입 실태와 관련 요인)

  • Lim, Jin-Hwa;Kim, Sung-Gyeong;Lee, Eun-Mi;Bae, Sin-Young;Park, Jae-Hyun;Choi, Kui-Son;Hahm, Myung-Il;Park, Eun-Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.2
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    • pp.150-154
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    • 2007
  • Objectives : The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. Results : Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of \65,311 and an average benefit amount of \19million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. Conclusions : About half of Korean people have supple-mentary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.

Trend and Prediction of Urban Family Expenditure for Health Care (도시 가계의료비 지출의 추이와 예측)

  • Park, Jae-Yong;Nam, Si-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.347-363
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    • 1995
  • The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. Consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series analysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis. so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.

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The Variation of HbA1c Examination Performance Rates among Diabetic Patients Using Ambulatory Care in South Korea (우리나라 외래서비스 이용 당뇨환자의 특성에 따른 당화혈색소(HbA1c)검사 시행률 변이 분석)

  • Hong, Jae-Seok;Kang, Hee-Chung;Kim, Jai-Yong
    • Health Policy and Management
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    • v.19 no.1
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    • pp.49-61
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    • 2009
  • Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.