• The Journal of Korean Obstetrics and Gynecology
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• v.21 no.3
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• pp.218-230
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• 2008

Purpose: This study was performed to investigate the percentage of the oriental medical Ob & GY disease group in Korean Medical Health Insurance and to gain the basic data of enlargement and improvement of Acupuncture Benefits in the oriental medical Ob & Gy field. Methods: We requested data about the status of Insurance Benefits in 2005. 2006 to Health Insurance Review & Assessmenstatus Service(HIRA). And on the basis of this 2005. 2006 data, we analyzed the status of Insurance Benefits and Acupuncture Benefits in the oriental medical Ob & Gy disease group. Results: 1. Total health care benefit costs of Korean medical health insurance in 2005, 2006 took 4.38 percent and 4.25 percent of total health care benefit costs of Health insurance. 2. Total health care benefit costs of the oriental medical Ob & Gy disease group in 2005, 2006 took 0.38 percent and 0.40 percent of total health care benefit costs of Korean medical health insurance. 3. The percentage of Acupuncture benefits costs of the oriental medical Ob & Gy disease group in 2005, 2006 was merely 0.22 percent and 0.23 percent of total Acupuncture Benefits costs. 4. The main sick and wounded name of Ob & Gy diseases of Acupuncture Benefits was limited to Menstrual Disorder(K01)과- Uterus Abnormality(K13). Conclusion: The percentage of the oriental medical Ob & Gy disease group in Korean Medical Health Insurance was very low and the percentage of Acupuncture Benefits of he oriental medical Ob & Gy disease group was also very low. From now on, Searching ay of enlargement of Acupuncture Benefits in the oriental medical Ob & Gy field is required.

• Health Policy and Management
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• v.7 no.2
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• pp.1-18
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• 1997

This study was conducted to analyze patient days and medical care benefits of finger-amputated patients due to industrial accident. The 161 personal data on medical care for finger-amputated patients due to industrial accident(88 in 1994, 73 in 1995) of Regional Labor Office and hospital characteristics were analyzed. The major results of this study were as follows : According to stepwise multiple regression analysis of patient days, number of amputated finger, location of hospital, bed capacity of hospital, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, sick leave benefits per day were the major significant variables in order. In stepwise multiple regression analysis with medical care benefits as a dependent variable, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, number of amputated finger, sick leave benefits per day, age, bed capacity of hospital were the major significant variables in order. The minimum optimal size with the lowest medical care benefits was a hospital with 300 beds. This shows that the economy of scale is also applicable for hospital industry. In summary, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, number of amputated finger, sick leave benefits per day, bed capacity of hospital were the major significant variables in both patient days and medical care benefits.

• Journal of Society of Preventive Korean Medicine
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• v.11 no.1
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• pp.139-151
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• 2007

This paper evaluated the benefits of the National Health Insurance(NHI) and suggested the necessity of extending some oriental medical services into the benefits schedule in the NHI. Comparing the rate of public financing in national health expenditure in OECD countries and measuring out-of-pocket payments in total medical cost showed the level of insurance payments to total medical cost is approximately $50%{\sim}60%$ in Korea, which is quite insufficient to pay household medical expenses, although the NHI covers the whole population. A few of consumers' priority surveys for medical needs suggested herb medicine, muscle treatment, and manufactured herb medicine be included in the list of the NHI benefits, based on efficiency and equity criteria. It was estimated that the NHI can afford to cover these three items of oriental medical services.

• Korea Journal of Hospital Management
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• v.20 no.1
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• pp.25-38
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• 2015

China has a growing number of medical tourists to visit South Korea every year, with economic growth, and thus Korea's medical tourism is growing countries in the new growth engine industries and attracting attention. In this study, this time looking at the risks and benefits of medical tourism potential factors consumers feel the Chinese people for South Korea medical tourism, economic, based on existing research, functional, temporal, social, and psychological setting factors, risks and benefits conducted a study of the relationship between the purchase of your help. Risk factors identified through this study, we investigate expanding the overseas medical tourism market to visit Korea by managing the benefits and know the strategic implications that can achieve customer satisfaction by the service convenient for Chinese tourists.

• The Journal of Economics, Marketing and Management
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• v.9 no.2
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• pp.45-55
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• 2021

Purpose: The purpose of this study is to investigate the theoretical basis for assessing the strategic increase in customer perception of service quality, justice, and relationship benefits. Especially in terms of increasing relationship commitment and customer loyalty in the medical service sector. Research design: Data were collected by questionnaires through specialized hospital services. Survey was conducted on patients who have been treated at a spine specialized hospital. Results: Research shows that service quality, justice, and relationship benefits have the greatest direct impact on relationship commitment, and relationship commitment has a strong direct impact on customer loyalty in the medical service organization. Conclusions: The effect of combination of core and voluntary service behavioral attributes such as service quality, justice and relationship benefits have the most positve impact on relationship commitment and customer loyalty. Administratively, this study contributes to understanding the role of service quality, justice, and relationship benefits in the medical service sector. The results showed that in order to induce service quality, justice and relationship benefits should be facilitated relationship commitment and customer loyalty enlarged.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.2
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• pp.77-81
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• 2011

Due to the increasing quantity of health services demand a wide range of growing medical markets and hospital through advanced, diversification can meet the needs of the patient. This hospital is having the introduction of expensive medical equipment. Because of this, hospitals are struggling to operate the hospital management. Therefore, when operating at the hospital before and after introduction of the most important factor in the interests of medical equipment through the analysis is directly related to hospital operations. CT study of the local clinics, or CR 40 where members of the medical equipment with 54 points against selected practitioners and hospital visits and interviews to investigate the expected benefits of each of the members raised an average of seven months to identify revenue performance caused by interests. Raised against the expected benefits resulting benefits to the overall average 87.43% did not meet the expected benefits. The hospital plans to introduce future when reviewing the medical equipment in consideration of the characteristics of the equipment requires a more solid plan, and whether the plan is properly implemented will be needed for the institutional verification capabilities.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.75-103
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• 2017

There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

• Health Policy and Management
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• v.34 no.1
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• pp.17-25
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• 2024

Background: This study aimed to assess the appropriate allocation of emergency medical beds across 17 provinces and presume the economic benefits associated with such allocation. Methods: To estimate the optimal allocation of emergency medical beds by province, data from the Statistics Korea's "cause of death statistics (2014-2021)," regional statistics on "area, population, gender, age," and "population projections" were utilized. The "number of emergency beds by city and district" provided by the Health Insurance Review and Assessment Service was also used. In estimating the economic benefits of preventing avoidable emergency deaths due to the expansion of emergency medical facilities, guidelines from the Korea Development Institute and the Korea Transport Institute were referenced to calculate the wage loss costs associated with emergency deaths and estimate the economic benefits. Results: The optimal ratio of emergency medical beds allocation by region was highest in Gyeonggi, Seoul, Gyeongnam, Gyeongbuk, and Busan, while Daejeon, Jeju, and Sejong showed lower ratios. Additionally, the prevention of avoidable deaths and economic benefits resulting from the increase in emergency medical facilities were highest in Gyeonggi, Seoul, Gyeongbuk, Gyeongnam, and Busan. However, when standardized by population, the prevention of avoidable deaths and economic benefits were analyzed to be highest in Gyeongbuk, Chungnam, Jeonnam, Gyeongnam, and Busan. Conclusion: The results of this study can serve as foundational data for future policy measures aimed at addressing the imbalance in the supply of emergency medical facilities across regions. Considering regional characteristics in the distribution of emergency medical facilities is expected to ultimately increase the efficiency of national finances and yield economic benefits.

• The Korean Society of Law and Medicine
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• v.8 no.1
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• pp.137-177
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• 2007

The medical expenses review system in Korea has developed under fee-for-service system with its own unique structure. The importance of reviewing medical expenses has been emphasized, as the size of medical expenditures moving through the health insurance legal context and its weight in the national economy have increased very rapidly. It is, however, analyzed that the feuds and arguments continue among the stakeholders for the lack of laws supporting the medical expenses review system. The medical expenses review is a series of administrative procedures, deciding whether claims from medical care institutions to the insurer are legal and valid or not. It mainly controls the increase of unnecessarily excessive health insurance claim and prevents fraudulent claim and abuse and checks the less use or unsuitable use of medical resources. It also works a function guarantees medical benefits for the appropriate treatment according to the object of health insurance system as a social insurance scheme. The dispute on legal base of the medical expenses review is about the source of law in the medical expenses review. There are the Health Insurance Act and administrative laws as jus scriptum and the guidelines of review as administrative orders. The medical expenses review should reflect various factors, such as the development of medical healthcare technologies, the health expenditures distribution, the financial situation of the health insurance, and the evaluation on the level of appropriate benefits. It is also likely to adapt to the traits of characters of medicine, and trends and transition, Besides it should judge the legality and the validity of medical benefits expenditures by synthesizing these all factors. And the evaluation system of appropriateness of medical benefits was administrative procedure which was consecutive with reviewing the medical expenses system and it was intended to make up for the result of reviewing the medical expenses in more comprehensive levels.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.