• Environmental Analysis Health and Toxicology
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• 제30권
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• pp.15.1-15.11
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• 2015

Objectives There has been a growing concern about the possible carcinogenic effects of the electromagnetic radiofrequency fields emitted from mobile phones. The purpose of this study was to investigate the association between mobile phone use and the development of gliomas in Korea. Methods Our study methods were based on the International Interphone study that aimed to evaluate possible adverse effects of mobile phone use. This study included 285 histologically-confirmed Korean patients 15 to 69 years of age, with gliomas diagnosed between 2002 and 2007 in 9 hospitals. The 285 individually matched controls were healthy individuals that had their medical check-up in the same hospitals. Unconditional logistic regression was used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for use of mobile phones. Results For the entire group, no significant relationship was investigated between gliomas and regular use of mobile phones, types of mobile phones, lifetime years of use, monthly service fee, and the other exposure indices. Analyses restricted to self-respondents showed similar results. For ipsilateral users, whose the body side for usual mobile phone use match the location of glioma, the aORs (95% CIs) for lifetime years of use and cumulative hours of use were 1.25 (0.55 to 2.88) and 1.77 (0.32 to 1.84), respectively. However, the contralateral users showed slightly lower risk than ipsilateral users. Conclusions Our results do not support the hypothesis that the use of mobile phones increases the risk of glioma; however, we found a non-significant increase in risk among ipsilateral users. These findings suggest further evaluation for glioma risk among longterm mobile phone users.

• 정신신체의학
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• 제2권1호
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• pp.22-33
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• 1994

The author presented several points of experienced materials obtained from the joint meetings of consultation-liaison Psychiatric division with oncologic department in Kyung Hee University Hospital. The joint meetings which have been held regularly every other week were very helpful not only for the psychiatrist but also for the cancer department stags to manage the cancer patients actively. The joint meetings have been progressed into more cohesive and active communication as time goes by. Most of the subjects discussed in the meeting was focused on the psychological and behavioral problems of the cancer patients. Besides, the difficulties arising from the chemotherapy were discussed. Probably the most difficult task for the treatment team was to provide complete information while respecting the patient's right to deny their situation The liaison psychiatrist usually gave comments to the charge doctor and/or nusing staff how to evaluate the patient's behavior and what would be the influential factors in developing the doctor-patient relationship. It was found that many cancer patients and their family members had their own peculiar illness behavior and disease concept which led patients to take non-medical or moreover, anti-therapeutic care. The family members were found to play an influential role in the choice of treatment method and progression of the disease. Another role of the liaison psychiatrist in the oncology ward was to encourage the treatment team members. In the practical point of view, it was not easy for the liaison psychiatrist to have time regularly for the cancer patients to encourage the liaison activities. And it seems to be fundamental that the consultation fee for the liaison psychiatrist should be set up at the resonable level.

• 보건행정학회지
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• 제9권2호
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• pp.95-117
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• 1999

The purposes of the study was to analysis the factors on the physicians' indemnity experience and indemnity on malpractice. Data was collected from mail interview for the physicians from August, to October in 1996. Questions were asked to the physician who selected with random sample(n=8.338) about the opinion of malpractice insurance. experience that he(she) have requested the indemnity from patience. context of experienced indemnity and demographic characteristics of physician and patience. Response rate is 37.5%(n=3,124). This study was analyzed in two levels' the first. influential factors on whether physician has experience of indemnity and the second. influential factors of indemnity among physicians who had experienced the indemnity. The major findings were as follows : 1. Logistic regression on whether physicians had experience of indemnity request was conducted. And it indicated that statistically meaningful variables of model 1 (about all physicians) were department of surgery, physicians who have intention of insurance fee, physician age and income, physicians who owned the hospitals and statistically meaningful variables of model 11 (about physicians who owned the hospital) were department of surgery and internal treatment. 2. Multiple regression on the influential factors on indemnity was conducted. And it showed that statistically meaningful variables in model 1 were method of malpractice quarrel(physician association), whether physician had malpractice, whether suit succeeded, physician age, average practice time and income and whether physician owned the hospital and statistically meaningful variables of model 11 were whether physician had malpractice, number of outpatient, number of beds. As the conclusion, the thesis was examined about the variables related with experience of indemnity and cost of malpractice. But in order to prevent malpractice and promote medical quality, the reasonable system to solve a malpractice have to settle and cost estimation on malpractice is essential. Therefore an advanced research is progressed with methodology to decide the indemnity bases.

• 보건교육건강증진학회지
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• 제16권2호
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• pp.205-233
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• 1999

This study is an effort to make policy suggestions by analysing the current health examination program as a benefit service provided by the national health insurance system, including health screening for the insured, screening of cancer and chronic diseases for their dependents. Analyses found some issues being gave attention to; 1) The insured under the community health insurance system do not get the health examination benefit. A program for them should be set to have equity in benefit services. 2) Low rates of using screen services compromise purpose and the efficiency the services have first intended to. An immediate attention should be made to increase low rate of use of screen test to detect chronic diseases in particular. 3) Selection of diseases and test items covered by health examination program does not reflect the need of the insured, but to reflect financial resources of the national health insurance system. 4) Lack of health screening facilities and their geographical maldistribution is observed, which with preference of a general hospital as a screening post by the insured may lead to unreliable test. 5) A follow-up system should have been developed for the suspected classified by test results of carrying chronic diseases. They should be cared for within the health examination program. Public health care systems incorporate such a system, along with caring for those who are in need of having a health counselling on preventive care. In conclusion, the national health insurance system should be a medical insurance of giving a higher priority on preventive care benefits, health examination program in particular. That could be done by making rearrangements of test items, screening methods and system, rationalizing current reimbursement system of service fee, increasing accessibility to and utilization of the services, and making an establishment of follow-up system.

• 종양간호연구
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• 제11권2호
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• pp.155-162
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• 2011

Purpose: The purpose of this study was to examine the actual care costs paid to Korean Oncology Advanced Practice Nurses (KOAPN). Methods: We collected data using a group discussion and questionnaire identified 115 tasks from job descriptions developed by the Korean Accreditation Board of Nursing. Forty-two KOAPN working at three university hospitals in Seoul were asked to evaluate each task as to type and whether the cost is paid or not. They were also asked to indicate the tasks in urgent need of development of a care cost with high priority. Results: Only five tasks (4.3%) related to treatment and complication related interventions or education were paid, and they were paid only once during the entire treatment period and were not covered by national health insurance. It was approved as a medical fee by health insurance review & assessment service. Furthermore, the names of the authority (doctor) and the actual provider (nurse) of the prescriptions were different for three of those tasks. Most of the suggested tasks needing development of care costs were actions specifically performed by nurses (physical-psychosocial-spiritual assessment, independent nursing interventions). Conclusion: KOAPN are currently paid for few tasks. To maximize the utilization of KOAPN, the establishment of a clear rational payment system directly related to their actual activities is needed.

• 보건행정학회지
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• 제30권2호
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• pp.164-177
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• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• 한국IT서비스학회지
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• 제16권3호
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• pp.17-45
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• 2017

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

• 보건행정학회지
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• 제16권1호
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• pp.17-40
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• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

• 대한예방한의학회지
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• 제6권2호
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• pp.36-47
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• 2002

Over thousands of years oriental traditional medicine has developed a theoretical and practical approach to treat and prevent diseases and to promote people's health in China and Korea. In China, the integration of traditional Chinese medicine into the national healthcare system began in the late 1950s. This was in response to national planning needs to provide comprehensive healthcare services. On contrary to China, South Korea established the parallel operation of two independent medical systems in 1952. Hence there has been a political conflict between oriental and modern medicine over issues of fee, the ability to sell and prescribe herbal medicines, and the licensing of practitioners in traditional medicines. Given this background. This study is to compare peoples' attitudes and opinions for oriental traditional medicine by ethnicity (Chinese, Korean-Chinese and Korean). Chinese and Korean-Chinese were more used and satisfied with traditional medicine treatment and traditional practitioners compared with Koreans. The proportion of Koreans who reported the cost of traditional treatments was expensive was higher than those of Chinese and Korean Chinese. Most of Chinese, Korean-Chinese, and Koreans reported that they would use traditional medicine: 1) when they would have some disease to be treated best through traditional medicine; and 2) when traditional practitioner had a reputation and lots of experiences for those diseases. Most Korean people reported that oriental and western practitioners should cooperate each other to improve the quality of care. Therefore, policy framework including integration of traditional and western medicine, regulation, etc. is needed. In addition, research is needed to determine which diseases is treated best through traditional medicine.

• 한국융합학회논문지
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• 제12권12호
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• pp.139-144
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• 2021

본 연구는 치과위생사의 치위생사정의 수행 실태를 조사하고, 치과의료기관 유형에 따른 수행 비율을 파악하기 위하여 수행하였다. 수도권 임상치과위생사 195명을 대상으로 설문조사를 시행하였고, 수행실태를 조사한 치위생사정 항목은 치과병력 채득, 의과병력 채득, 생징후 측정, 구외 검사, 구내 검사, 치주조직 검사로 총 6가지였다. 연구 결과 수행 비율이 가장 높은 항목은 치과병력 채득 92.8%였고, 가장 낮은 항목은 구외 검사 57.9% 였다. 치과 유형에 따른 치위생사정 수행률을 비교하면, 모든 항목에서 치과의원이 치과병원과 대학병원에 비해 높았으며 특히 구내검사와 구외검사 수행률이 치과의원에서 높게 나타났다. 본 연구를 통해 전반적으로 높은 치위생사정 수행률을 볼 때, 임상 실태를 반영하지 못하는 치과위생사의 법적업무에 대한 논의와 일부 치위생사정 항목에 대한 보험수가 반영이 필요할 것이다.