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Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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The Study about Role and Importance of Site Activity Stage in Safety Activity for the International Conference among Several Countries (다자간 국제회의 안전활동에 있어서 현장활동단계의 역할 및 중요성에 관한 연구 : 부산 APEC 행사를 중심으로)

  • Lee, Sun-Ki
    • Korean Security Journal
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    • no.19
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    • pp.105-138
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    • 2009
  • This study's purpose is to present the improvement of effectiveness of security activity for international conference among Several Countries which can be held hereafter. On the basis of security activity problems originating in APEC that had been held in Busan in 2005. I made up questions three times to on the members of the police, military, fire figher and national intelligence service who had experienced in Busan APEC and recognition of possible problem and possibility of improvement on each item of questions was analyzed by Delphi Method. Also interviews with 4 security experts selected from each security agency were conducted to present improvement in each part of problem. The results obtained from the face to face interview with four experts of security-enforcement agency about the role and importance of site activity stage for international conference among several countries are as followings ; First, the system that experienced security-enforcement agents can be selected for the next national security event is needed, by data-basing the security-enforcement agents who were experienced in security event as man power management. Second, the middle-term plan for the introduction of high-tech equipment and joint inspection with relevant security agents are needed for the efficient explosive technical detection. Third, high-tech security equipment could be introduced through the international high-tech security equipment exhibition. Fourth, an anti-terrorism plan should be measured by sharing information through the cooperation with domestic and international intelligence agency. Fifth, public relations should be measured systematically by organization rather than agents' individual public relations. Sixth, political consideration to secure integrative coordination with other agency is needed for security activity, through normal cooperation with fire fighting related agency such as an electric, gas, elevator company. Seventh, a definite press guideline is needed for a convenient news coverage and safety during security event.

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A Study on the Characteristic of Treatment and Dental Caries Occurrence after the Insurance Benefit about the Pit and Fissure Sealing (치면열구전색술에 대한 보험급여 이후 진료특성 및 치아우식 발생에 관한 연구)

  • Sung, Soon-Im;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.654-661
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    • 2016
  • This study was conducted to investigate treatment tendency and dental caries occurrence after receiving insurance coverage for pit and fissure sealing. Data were obtained from statements for insurance payments received by the Daejeon branch health insurance review and assessment service from December 2009 until December 31 2014. As to the Pit and Fissure Sealing current state by year, there was most a lot of the number of examinee and the treatment number of teeth in 2010. The per capita average treatment number of teeth was highest (3.39) in 2013. As to the result that it analyze the first molar Pit and Fissure Sealing in 2010 according to the general feature, man was high than the woman, it showed up by age in the age of 7 most highly, and the summer was the highest among by season. The upper jaw left first molar was the most common location, although the upper jaw on the right side first molar, lower jaw right side first molar, and lower jaw left first molar were also affected. In 2010, the procedure was conducted more in the upper jaw right side first molar and enforces the recharge since 2011 to 2014, men were treated more than women, the recharge which is the most abundant in the age of 7 was performed by age, and the procedure was performed more during summer than in other seasons. It is forecasted that at August, 2015 most high demand shows according to the result that it predicts the tooth treatment number until December 2015 based upon the treatment number of teeth from December 2009 until November 2014 and be reduced in comparison with the year 2014. Thus, tooth brushing alone is not sufficient to prevent dental caries. Indeed, conducting pit and fissure sealing in infants and toddlers, as well as elementary middle and high school oral health centers is expected to be effective at preventing dental caries.

Change of Flora of Damaged Land in Juwangsan National Park for Five Years (2010~2014) (주왕산국립공원 내 훼손지의 5년간(2010~2014년) 식물상 변화)

  • You, Juhan;Kim, Mijin
    • Journal of Environmental Impact Assessment
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    • v.25 no.4
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    • pp.233-247
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    • 2016
  • The purpose of this study is to offer the basic data for management of National Park by surveying and analysing the change of flora of damaged lands in Juwangsan National Park, Korea. In cause of occurring the damaged lands, site-1 was the vegetation damage by stamping, the removing Gwangamsa of site-2, 3, 4 and the removing Naewon village of site-5, 6, 7. Whole sites are caused by the artificial disturbance and interference. The numbers of flora were summarized as 135 taxa including 52 families, 109 genera, 116 species, 2 subspecies and 17 varieties in whole sites. The status of flora by sites, site-6 is the largest number of 52 taxa, site-1 is the lowest of 23 taxa. The rare plant is 1 taxa, 4 taxa of endemic plants, 10 taxa of specific plants by floristic region, 9 taxa of naturalized plants and 1 taxa of invasive alien plant. In the results of analysis about the change of coverage ratio, for this shrub layer, site-7 was changed to the most $0%{\rightarrow}50%$, and the herb layer, site-5 was changed to the most $75%{\rightarrow}95%$. In case of the change of species numbers, most sites tended to increase in the sites introduced different species or generated by the growth. It is contemplated that is similar to the restoration with the surrounding natural vegetation that is in progress is a transition occurs with the passage of time. In the dominant species, the shrub layer is Fraxinus sieboldiana, Lespedeza bicolor, Rhus javanica, Lespedezamaximowiczii, Salix koreensis and Zelkova serrata, and Miscanthus sinensis var. purpurascens, Oplismenus undulatifolius, Artemisia princeps, Bothriochloa ischaemum and Erigeron annuus of herb layer. In the results of analysing Naturalized Index(NI) and Urbanized Index(UI), NI was increased or decreased this phenomenon with the lapse of time, UI was the most increase. In particular, the increase in UI is due to the transition process, the pioneering plant, naturalized plant was imported to continue.

Relationships of Obesity, Total-Cholesterol, Hypertension and Hyperglycemia in Health Examinees with Disabilities (장애인 건강검진 수검자들의 비만, 콜레스테롤, 고혈압, 고혈당의 관련성)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.591-599
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    • 2016
  • Among the employer-supported subscribers to the National Health Insurance Service, 6,797 people with mild disabilities with western ages of 20 and up and who received health checkups were investigated. Of these 6,797 people, 3,186 and 3,611 received health checkups in 2009 and 2013, respectively. Those people who were diagnosed with physical handicaps, brain lesions, visual impairment, hearing impairment, intellectual disabilities, mental disorders, kidney disorders or other disorders according to the classification standard for people with disabilities were classified into disability groups of the 3rd through 6th degrees. The purpose of this study was to examine the dangerous influence of obesity of people with mild disabilities on their hyperglycemia, hypertension and high cholesterol. The items measured in this study were abdominal obesity, body mass index, fasting glucose, total cholesterol, systolic blood pressure and diastolic blood pressure. To look for connections between the obesity level and at-risk groups for each disease, cross tabulation and multinomial logistic regression analyses were utilized. Higher levels of abdominal obesity and BMI were found among those who were male, were younger and had higher incomes. The risks of abdominal obesity and BMI were higher in the abnormal groups for each disease. In 2009, the obesity group whose BMI was higher had a 1.51-fold higher risk of hypertension than the normal group. The abdominal obesity group had a 1.59-fold higher risk of high cholesterol, a 1.26-fold higher risk of hypertension and a 1.54-fold higher risk of hyperglycemia than the normal group. In 2013, the obesity group whose BMI was higher had a 1.72-fold higher risk of high cholesterol and a 1.43-fold higher risk of hypertension than the normal group. Those with abdominal obesity had a 1.59-fold higher risk of hyperglycemia than the normal subjects. As the risk of obesity was higher in those with disabilities than in those without disabilities, the former should be encouraged to undergo health checkups on a regular basis, and the coverage of the health checkups should be extended to keep track of their illness. In addition, appropriate education and concern are both required to prevent obesity.

Correlation of Unmet Healthcare Needs and Employment Status for a Population over 65 Years of Age (65세 이상 인구의 고용형태와 의료요구 미충족 경험률의 관련성)

  • Kang, Jeong-Hee;Kim, Chul-Woung;Seo, Nam-Kyu
    • 한국노년학
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    • v.37 no.2
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    • pp.281-291
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    • 2017
  • The present study aimed to investigate the rate of unmet healthcare needs for elderly over the age of 65 years, as well as analyze the relevance between employment status and unmet healthcare needs due to financial reasons. With regard to the study method, a logistic regression analysis was performed to investigate the correlation between employment status and unmet healthcare needs due to financial reasons, targeting 5,528 subjects over the age of 65 years. The results showed that the rate of unmet healthcare needs was 18.9%, in which the rate of unmet healthcare needs due to financial reason was 8.1%. The rate of unmet health needs was higher for temporary workers(ORs=1.75) than for retirement workers. However, the rate of unmet healthcare needs caused by financial reasons was higher among day workers(ORs=1.92). In conclusion, in order to prevent unmet healthcare needs for senior Korean patients, it is necessary to not only improve the income security system for the elderly, but also improve the occupational form and level of income of these economically active citizens, considering the increase in average life expectancy. Moreover, it is also necessary to reinforce health insurance coverage systems for settling medical expenses.

A study on mandatory insurance for aircraft operators (항공보험 가입의무에 관한 연구)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.169-197
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    • 2018
  • The purpose of this study is to present a reasonable and concrete standard for the Korean aviation insurance compulsory subscription system. Through this, we aim to improve the current revision of laws and regulations, and ultimately create an environment in which the safety and property of the Korean people who use aircraft with appropriate aviation insurance can be secured. In particular, by reviewing the aviation business law and its new laws and regulations enacted in 2017, the legislative improvement direction of aviation insurance will be proposed. In order to maintain the continuous growth of the air transportation industry and to make amicable compensation for the victims, considering the characteristics of the total accident, instantness, and giganticness of air accidents in which a lot of people and property are lost in the event of an accident, adequate insurance coverage is essential. In this respect, the compulsory insurance to amend the principle of freedom of contract, which is the great principle of the modern judicial system, will be persuasive. However, in comparison with foreign legislation, the legal provisions on Korea's obligation to comply with aviation insurance need to be revised around the following issues: First, it is reasonable to enforce the regulation of the mandatory aviation insurance by legislation from the Congress not by administrative regulations. Because it will force the monetary obligations of the individual such as common air carriers. Second, our law regulations respond to various kinds of air damages by using the phrase "limit of liability stipulated in international conventions". However, as we have seen in the text, the range of compensation are various according to the use of legal instruments in international conventions such as the Montreal Convention, which governs the compensation of passengers for damages to passengers today. Third, in countries with narrow territories, such as Korea, there are big differences in flying time and insurable risk between domestic and international transportation. Therefore, it is necessary to divide domestic transportation and international transportation even in the obligation to join the insurance. This dual discipline has the advantage for rookies in air carrier market who mainly start their business from domestic service. Fourth, according to Korean law, the regulations of automobile loss insurance is applicable to the aviation mandatory insurance of unmanned aerial vehicle accident which is lack of persuasion. In the future, it will be appropriate to discipline insurance for unmanned aerial vehicles with unlimited potential for development from a long-term perspective.

Factors Affecting the Negative Perception of Public Hospitals among Local Residents (지역 주민의 공공병원에 대한 부정적 인식에 영향을 미치는 요인)

  • Eun Hye Choi;Jung Hee Cho;Kyoung Eun Yeob;Bo Hui Park;So Young Kim;Jong Hyock Park
    • Health Policy and Management
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    • v.34 no.2
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    • pp.211-221
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    • 2024
  • Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.

A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement (한방건강보험 약제 투약 실태 및 활성화 방안 연구)

  • Kwon, Yong-Chan;Yoo, Wang-Keun;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.27 no.2
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

Community Distribution on Mountain Forest Vegetation of the Gyebangsan Area in the Odaesan National Park, Korea (오대산 국립공원 계방산 일대 삼림식생의 군락분포에 관한 연구)

  • Kim, Chang-Hwan;Oh, Jang-Geun;Kang, Eun-Ok;Yun, Chil-Sun;Lim, Jin-Keun
    • Korean Journal of Ecology and Environment
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    • v.47 no.3
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    • pp.135-145
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    • 2014
  • The mountain forest vegetation of Gyebangsan (1,577 m) in Odaesan National Park is classified into deciduous broad-leaved forest, mountain valley forest, coniferous forest, subalpine coniferous forest, subalpine deciduous forest, plantation forest, and other vegetation which includes Actinidia argute community and agricultural land. As for the number of communities distributed in the each forest vegetation which were categorized by the physiognomy classification, deciduous broad-leaved forest had 33 communities, mountain valley forest 41 communities, coniferous forest 8 communities, subalpine coniferous forest 4 communities, subalpine deciduous forest 2 communities, plantation forest 6 communities and other vegetation 4 communities. Regarding the distribution rate of communities in the vegetation, in the deciduous broad-leaved forest. Quercus mongolica community accounted for 80.226% with $30,909,942.967m^2$, followed by Quercus variabilis community of 2.771% with $1,067,479.335m^2$. 55.463% of deciduous broad-leaved forest in the Gyebangsan had Quercus mongolica as a dominant or second dominant species. In the mountain valley forest, Fraxinus rhynchophylla - Juglans mandshurica community accounted for 10.955%. And there were ten mixed communities having Fraxinus rhynchophylla and upper layer at a similar level of coverage, taking up 32.776%. In the coniferous forest, Pinus densiflora and the community living with Pinus densiflora accounted for 100%, showing that the coniferous forest has the community with Pinus densiflora as a dominant species at upper layer. For other vegetation, subalpine coniferous forest had a total of four communities including Abies holophylla - Quercus mongolica community, and accounted for 4.980% of vegetation area of Odaesan National Park. Two communities including Betula ermani - Cornus controversa community were found in the subalpine deciduous forest, taking up 0.006% of total vegetation area of Odaesan National Park. Regarding plantation forest, Larix leptolepis was planted the most with 51.652%, followed by Betula platyphylla var. japonica with 38.975%, and Pinus koraiensis with 7.969%. These three species combined accounted for 98.565%. In conclusion, the forest vegetation found in the Gyebangsan of Odaesan National Park has Quercus mongolica as a dominant species at the top layer. A lot of other communities related with this species are expected to be quickly replaced due to vegetation succession and climatic causes. Therefore, Quercus mongolica is expected to become the main species in the deciduous broad-leaved forest, Fraxinus rhynchophylla, Juglans mandshurica and Fraxinus mandshurica in the mountain valley forest. Around the border line between deciduous broad-leaved forest and mountain valley forest, highly humid valley area is expected to be quickly taken up by Cornus controversa and Fraxinus mandshurica, and the slope area by Quercus mongolica. However, in the subalpine coniferous forest, the distribution rate of deciduous broad-leaved trees is expected to increase due to climate warming.