• Title, Summary, Keyword: Medical Burden

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A Study on Factors Causing the Burden of Medical Expenses to The Elderly with Chronic Disease (만성질환 노인의 의료비부담 관련요인에 관한 연구)

  • Kim, Mee-Hye;Kim, So-Hee
    • Korean Journal of Social Welfare
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    • v.48
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    • pp.150-178
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    • 2002
  • The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

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A Study on the Association between Healthcare Utilization and the Burden of Families Caring for the Elderly in the Last 6 Months of Life (노인의 사망 전 6개월간 의료이용수준과 간병가족의 가족부담과의 관련성)

  • Yi, Jee-Jeon;Lee, Hee-Na;Ohrr, Hee-Choul;Jung, Hye-Young;Yi, Sang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.332-338
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    • 2003
  • Objective : To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. Methods : The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. Results : 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age af death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. Conclusion : An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.

The Development on Medical Malpractice Lawsuit and its Burden of Proof (의료과오소송 입증책임론의 전개와 발전)

  • Shin, Eun-Joo
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.9-56
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    • 2008
  • The medical practice does not always get a satisfatory result since the disease progress of patients are depended on patients' physical constitution and the doctors cannot control the outcomes about patients' physiological and biological reaction after the treatment. Moreover, the medical practice may bring wrong result fatalistically because of the unpredictablility of life. To demand for compensation of the damage to the doctors about these wrong result, the patient side holds the burden of proof that is between medical practice and demage, and there is damage from doctor's malpractice according to the accepted theory about the fundamental principle of distribution of the burden of proof. This falls not only under the liability of Tort Law, but also liability of Contract Law. However, the patient may be in difficult situation to prove the malpractice of doctors since he or she cannot recognize the facts because he or she was in unconscious while the medical practice was conducted, or they cannot judge precisely even though they recognize the facts. Nevertheless, the lawsuits against medical malpractice are the field that never achieves the equality of arms since the most of the evidence belong to the doctor's side. Hence, to maintain the principle of the equality of arms under the constitution, the theory leads to alleviate the burden of proof that patients hold. However, the doctors cannot be asked for the burden of proof that they conduct medical practice without errors. Because the doctors may experience difficulty to prove their innocence as the patients because of the unique characteristic that medical practices have. Therefore, the methods of the alleviation of the patient's burden of proof should have the equality of arms and the equal opportunity between the patients and the doctors with the evaluation of the justifiable interest from both the patients and the doctors. As the methods of the alleviation of the burden of proof, the alleviation of the demands and the degree of the burden of proof or resolutely the conversion of the burden may be considered. However, Recognizing the exception from general principle with converting the burden of proof is not proper in principle because the doctors may experience difficulty of the proof as the patients may have. If the difficulty of proof can be resolved by alleviating of the demands and the degree of the burden of proof, it is more desirable resolution rather than converting the burden of proof.

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Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea (국가 암 비용 감소를 위한 환자중심 진료의 적정성 확보 전략)

  • Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.4
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    • pp.217-227
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    • 2017
  • In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

Legislation Trend Referring to Burden of Proof in Medical Malpractice Lawsuit (의료과오소송 입증책임 관련 입법의 동향)

  • Cho, Hyong-Won
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.129-162
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    • 2008
  • Nowadays it is important for us to resolute medical disputes. Because a high incidence of medical accidents may be brought about according to many chances of treatment in the operation of health insurance and increasing concern of patient health. Patients and medical doctors have plenty of difficulty in uncomfortable treatment circumstances of a high incidence of medical accidents. It is especially desirable that our society should prevent medical accidents and resolute speedy, fairly and rationally the happened medical disputes. Many legislations were suggested to resolute medical dispute. But legal issue points stress only speedy medical dispute resolution procedure and don't compromise fair and professional procedure. Accordingly these legal arguing points had not been accepted by the National Assembly and people. If the speedy resolution of medical dispute was demanded to solve unsafe treatment circumstances, it is necessitated that the legislation containing legal issue points to procedure is enacted. Of course the interest of patients and doctors to legal issue points must be balanced. Because an arguing points to the reversal of proof burden is consisted of the entity judgement in connection with setting the basis of resolution of medical dispute, the legislation to these is checked carefully.

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Factors Affecting Perceived Financial Burden of Medical Expenditures (건강보험 입원환자의 주관적 의료비 부담에 영향을 미치는 요인)

  • Choi, Young-Soon;Lee, Kwang-Ok;Yim, Eun-Shil
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.2
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    • pp.147-157
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    • 2011
  • Purpose: This study was done to investigate factors affecting perceived financial burden of medical expenditures. Method: The participants were 2,024 inpatients who were enrolled in a survey on the benefit coverage rate of the National Health Insurance in 2006. The collected data were analyzed using t-test, ANOVA-test, Mann-Whitney-test, Kruskal-Wallis-test, Chi-square test and logistic regression. Results: The crucial factors for perceived financial burden were age, job, equivalence scale, ratio of annual family income vs medical expenditure, and private health insurance. Perceived financial burden was higher for people who were older, who were unemployed, whose medical expenditures were high compared to annual family income, whose index of family equalization was low and for those who had no private health insurance. Conclusion: The results of the study indicate a demand for system reform that will enable management of no-pay hospital bills in the National Health Insurance to decrease the medical expense of people in the low-income bracket.

Judgement of causation and burden of proof in medical malpractice litigation (의료과오소송에 있어서 인과관계의 판단과 입증책임에 관한 판례의 최근 경향 - 일본 판례와의 비교를 중심으로 -)

  • Baek, Kyoung-Hee
    • The Korean Society of Law and Medicine
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    • v.8 no.1
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    • pp.179-211
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    • 2007
  • To succeed the claim of medical malpractice litigation, the patient as a plaintiff should establish the medical fault of a physician as a defendant, and the causation between the fault and damages. Because of the extraordinary nature of medical province, however, this application of a legal principles is rigorous with the patient. In addition, given the causation between the validation of physician's fault and damage is not attested, patient is not awarded anything. In order to overcome a difficulty of patient's verification and ensure the right to fair process, it was demonstrated the lightening of burden of proof in medical malpractice litigation and the acceptance of the responsibility for an illegal act in a prescribed range in the absence of the causation between the physician's fault and damage. This paper deals with the judgement of causation and burden of proof in medical malpractice litigation, and the acceptance of responsibility in the absence of the causation between the physician's fault and damage. Also, this study recommends a tendency of our precedent through the comparative case method of ours and Japan.

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What is needed for the success of national responsibility for dementia (치매국가책임제가 성공하려면)

  • Lee, Dong Woo
    • Journal of the Korean Medical Association
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    • v.60 no.8
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    • pp.618-621
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    • 2017
  • Dementia is a chronic, disabling illness which is most feared by elderly people. Dementia causes heavy caregiver burden on the family. Dementia also imposes much burden on the society, making it one of the major public health problem in many countries. Actually, Organization for Economic Cooperation and Development recommended to pose a priority to dementia management as a public health task. As the Korean population is rapidly aging, there is a rapid increase of people with dementia in Korea. In Korea, the people with dementia doubles every 15 years, and the economic burden of care for dementia doubles every 10 years. To cope with this rapidly increasing burden of dementia, Korean government has launched: plan for national responsibility for dementia. The plan is composed of distributing dementia reassuring center nationwide, setting up dementia reassuring hospital, and decreasing the burden of paid money for medical treatment and long-term care for dementia. The major hurdles in implementing the plan and the strategies to overcome such hurdles by public-private collaboration are suggested.

The Relationship between Family Burden and Mental Health Service Needs of Family for Home-based Chronic Mental Patients in Community (지역사회 재가 만성정신질환자 가족의 부담감과 정신보건서비스요구와의 관련성)

  • Kim, In-Hong
    • Journal of agricultural medicine and community health
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    • v.33 no.3
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    • pp.269-278
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    • 2008
  • = ABSTRACT = Objectives: This study was carried out to identify the relationships of family burden and mental health service needs of chronic mental patients in community. Methods: Objects of the study were 153 chronic mental patients in community of P. city in korea. Data were collected from December, 2007 to February, 2008 using structured questionnaire. Research tools of this study were family burden tool developed by Pai & Kapur (1981) and mental health service needs tool developed by Kim (2003). Results: The average grades for family burden was 1.62 points. And the biggest part of family burden was economic burden(1.74), followed by interrupt of daily life(1.67), interrupt of family relationship(1.64), interrupt of family leisure (1.57), effects of mental health(1.50), and effects of physical health(1.43). The average grades for mental health service needs was 2.72 points. And the biggest part of mental health service needs was rehabilitation service(3.09), followed by social service(2.87), and Psychiatric medical service(2.21). Positive correlation showed between all parts of family burden. And, positive correlation showed between psychiatric medical service and interrupt of daily life(r=.281, p<.01), psychiatric medical service and effects of physical health(r=.355,p<.01), social service and effects of mental health(r=.213,p<.01). Conclusion: The family burden for care giver of mental patients was related with all parts of family burden and mental health service needs of family. Thus, these results should be considered to reduce family burden for care giver of mental patients in community.

Burden of Hepatocellular Carcinoma in Asia

  • Fazeli, Zeinab;Pourhoseingholi, Mohamad Amin;Vahedi, Mohsen;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.5955-5958
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    • 2012
  • Hepatocellular carcinoma (HCC), the sixth most prevalent cancer worldwide, continues to have high prevalence in many countries of Asia. The main challenge is the high prevalence of chronic hepatitis and aflatoxin, for example in China. HBV vaccination should be the major preventive tactic in Asian countries. The burden of HCC is low in Iran because most cases are due to HBV and this infection was less common. Although in Iran, a mass vaccination program started in 1993, its impact on decreasing the burden of HCC due to HBV can only be expected in future decades.