• 의료법학
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• 제8권2호
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• pp.37-68
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• 2007

Health insurance has gone far toward solving Korea's health related problems through thirty years. Health Insurance as social security system has a role of national system to secure national health. But there are many problems in health insurance. There is a dispute about many issues, coverage of health security, compulsory appointment of health insurance organization, coverage and level of health insurance benefit, decisionmaking right of health insurance price, examination of health insurance etc. Generally, the opinion for health insurance policy to be leaded by nation sets against the opinion to be leaded by private sector. It is necessary to study politics of law, constitute law and comparative law for rational solving these problems. If desirable setting of health law system can be made, legal system must be set during a long time and be discussed synthetically in different standpoint.

• 대한한의학회지
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• 제30권4호
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• pp.64-78
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• 2009

Objectives: To research Korean oriental medical doctors' use of uninsured herbal extracts and how to bring about the insurance coverage of such herbal extracts. Methods: We surveyed Korean oriental doctors about the following issues from October 17th to November 15th, 2008: (1) Korean oriental medical doctors' knowledge about herbal extract insurance and the circumstances of oriental medicine in Korea, (2) their opinion on the coverage of currently uninsured herbal extracts and the dispensing of herbal extracts from pharmacies rather than from their clinics, (3) their use of herbal extracts, and (4) how to bring about insurance coverage of uninsured herbal extracts. Results: Over 70% of the respondents said that herbal medicine prescriptions have been reduced recently and that the existence of herbal medicine is in danger. In addition, 63.64% respondents agreed with expanding insurance coverage to include currently uninsured herbal extracts in spite of the fact that patients might have to obtain herbal extracts from pharmacies rather than from Korean oriental medical clinics. The average patient number per month of uninsured herbal extracts was 13.64 people, the average dosage was 5.64g, the average cost per day was 3,859 won, and the average prescription period was 2.65 days. Korean oriental medical doctors asked an average of 12,486 won for the medical examination-prescription fee and 3,292 won in fees for prescriptions obtained outside the hospital. If insurance coverage expands to include these herbal extracts, their usage is expected to increase 2.31 times. Conclusions: This study shows Korean oriental medical doctors' use of herbal extracts and their opinions about execution of herbal extracts' insurance. A periodic study such as this one will hopefully aid in establishing polices for uninsured herbal extracts' insurance.

• 대한예방한의학회지
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• 제26권1호
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• pp.25-41
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• 2022

Background & Objectives : As the government of South Korea implemented policies to strengthen health insurance coverage, the health insurance benefit for raw herbal medicines has been promoted. This study investigated the current status of the herbal medicines coverage in the Japanese national health insurance to secure reference data for the design of herbal medicines coverage in South Korea. Methods : Literature review was conducted to collect and analyze the history and current situation on herbal medicines coverage in the Japanese health insurance system. To supplement the contents not presented in the documents, on-site interviews were conducted at the medical institutions and pharmacies that prescribed or prepared herbal medicines in Tokyo, Japan. The contents of the survey included the background and progress of the herbal medicines coverage, the status of herbal medicines use, the payment system, and the safety management of herbal medicines. Results : Since the introduction of health insurance in the 1960s, Japanese insurance system has covered herbal medicines, and so far, it has been maintained without any additional restrictions. When the raw herbal medicines are prescribed to outpatients, the preparation fee is set higher than that of other medicines, but overall payment regulations and systems for herbal medicine are generally the same as other medicines. Conclusions : The case of Japan can be a useful references and implications for national health insurance policy on herbal medicines in south Korea.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.14-19
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• 2016

Background: This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions. Methods: This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service. We identified developments over the 5-year time period and analyzed the level of regional imbalance regarding cardiovascular surgery through the relative comparison of relevance indexes between cardiovascular and other types of surgery. Results: The relevance index was high in large cities such as Seoul, Daegu, and Gwangju, but low in regions that were geographically far from the capital area, such as the Gangwon and Jeju areas. Relevance indexes also fell as the years passed. Cardiovascular surgery has a relatively low relevance index compared to key types of surgery of other fields, such as neurosurgery and colorectal surgery. Conclusion: This study identified medical service use imbalance between regions for cardiovascular surgery. Results of this study demonstrate the need for political intervention to enhance the accessibility of necessary special treatment, such as cardiovascular surgery.

• 대한한의학방제학회지
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• 제18권1호
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• pp.43-56
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• 2010

Objective : There is a growing need to expand or adjust insurance coverage of herbal prescriptions in National Health Insurance. The purpose of this study was to provide basic data for expansions or adjustments of 56 herbal prescriptions in the National Health Insurance. Method : We surveyed lists of 56 insurance-covered herbal prescriptions, non-covered company-produced herbal medicines and self-prepared herbal medicines in 531 traditional korean medical clinics by mail from 6/1/2008 to 12/9/2008. Result : Among the 56 Prescriptions, Ojeok-san was stocked in 66.7% of clinics (1st), Samso-eum ranked 2nd, Socheongnyong-tang ranked 3rd, Gumiganghwal-tang was 4th, Hyangsapyeongwi-san ranked 5th. Among the non-covered company-produced herbal medicines, Danggwisu-san ranked 1st, Gwakyangjeonggi-san ranked 2nd, Oryeong-san was 3rd, Bangpungtongseong-san was 4th, Maengmundong-tang ranked 5th. Among the self-prepared herbal medicines, Gongjin-dan ranked 1st, Soche-hwan was 2nd, Gyejibongnyeong-hwan was 3rd, Yeongsin-hwan was 4th, Palmi-hwan ranked 5th. Conclusions : It is reasonable to select frequently used company-produced or self-prepared herbal prescriptions in this stock rate survey for improvement of National Health Insurance coverage.

• 보험의학회지
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• 제15권
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• pp.141-147
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• 1996

• 보험의학회지
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• 제32권2호
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• pp.39-49
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• 2013

The textbook of insurance medicine is very bulky volume and it's revision time may be long. Nowadays medical knowledge and evidences are developing rapidly. It is necessary to revise current insurance risk of certain disease. Review of respiratory diseases in terms of insurance medicine may be valuable information for insurance doctors and life underwriters. Newly estimated mortality ratio and excess death rate of several respiratory diseases in this review are organizing pneumonia, 266%/44‰; multi-drug resistant tuberculosis, 1200%/110‰; idiopathic interstitial pneumonia, 869%/85‰; VATS lobectomy of stage I lung cancer, 550%/33‰; lymphangioleiomyomatosis 9826%/66‰; lung transplantation 2026%/92‰, respectively.

• Tuberculosis and Respiratory Diseases
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• 제64권5호
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• pp.369-373
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• 2008

결절성경화증은 유전성 신경피부 증후군으로 피부, 뇌, 신장 등의 여러 장기에 과오종을 형성하는 질환이다. 결절성경화증의 폐 침범은 드물지만 다발성 미세결절의 소견을 보이는 경우, 정확한 진단을 위해서는 고해상 흉부 전산화 단층 촬영 및 조직 검사가 필요하겠으며, 다발성 미세결절폐세포증식증을 감별 진단으로 고려해야 할 것이다. 이 질환의 임상적 의의 등 아직 알려진 것이 많지 않으나 현재까지의 보고로는 특별한 치료는 없으며 예후는 좋은 것으로 알려져 있다.

• 대한한의학회지
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• 제30권1호
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• pp.1-16
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• 2009

Objectives: To study the standard herb prescriptions based on the specific names of the sick and wounded for the application of Eastern Medicine Health Insurance. Methods: We selected 678 herb prescriptions from the eleven Eastern medical books recognized by the Ministry for Health of Korea and then researched the concrete opinions of Korean Oriental Medicine Societies (KOMS) on those herb prescriptions from July 31, 2006 to August 31, 2006. Results and Conclusions: KOMS said that 80 herb prescriptions must be included and 26 herb prescriptions must be excluded. They also said that the proper numbers of the specific names of the sick and wounded for the application of Eastern Herbal Medicine Health Insurance were 20-29 and the proper range of herb prescription change was within 30 percent.

• Journal of Preventive Medicine and Public Health
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• 제22권2호
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• pp.189-196
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• 1989

In January 1988, district medical insurance plan was executed on a national scale in Korea. We conducted an evaluation of the impact of execution of district medical insurance plan on number of hospital patients: number of outpatients; and occupancy rate. This study was carried out by Box-Jenkins time series analysis. We tested the statistical significance with intervention component added to ARIMA model. Results of our time series analysis showed that district medical insurance plan had a significant effect on the number of outpatients and occupancy rate. Due to this plan the number of outpatients had increased by 925 patients every month which is equivalent to 8.3 percents of average monthly insurance outpatients in 1987, and occupancy rate had also increased by 0.12 which is equivalent to 16 percents of that in 1987.