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Dilemmas Within the Korean Health Insurance System

The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insuran...

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Detalles Bibliográficos
Autores principales: Park, Donghwi, Chang, Min Cheol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Preventive Medicine 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411252/
https://www.ncbi.nlm.nih.gov/pubmed/32752598
http://dx.doi.org/10.3961/jpmph.20.074
Descripción
Sumario:The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.