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KMID : 1044620200530040285
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Journal of Preventive Medicine and Public Health
2020 Volume.53 No. 4 p.285 ~ p.288
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Dilemmas Within the Korean Health Insurance System
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Park Dong-Hwi
Chang Min-Cheol
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Abstract
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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.
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KEYWORD
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Health insurance system, Health Insurance Review and Assessment Service, Payment, Patient, Korea
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