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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Bibliographic Details
Main Authors: Donghwi Park, Min Cheol Chang
Format: Article
Language:English
Published: Korean Society for Preventive Medicine 2020-07-01
Series:Journal of Preventive Medicine and Public Health
Subjects:
Online Access:http://www.jpmph.org/upload/pdf/jpmph-20-074.pdf
Description
Summary: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.
ISSN:1975-8375
2233-4521