Hospital bursar is a governmental policy aiming at mobilization of community contribution to improve the quality of treatment and consultation. Hospital fee collection depends on various different subjects such as medical insurance patients, a partial remised patients. Hospital objective is equity, effective and quality. The result: the total of remised expenditures is direct proportional to increasing collection from hospital fee. The rate of hospital fee is the most increasing in hospitals. The rate of remission is the most increased in Central hospitals. It is necessary to extract from poverty reduction and hungry -alleviation fund to help the poor population in consultation and treatment in corresponding to the subject
Civil Rights ; Delivery of Health Care

The purpose of this thesis is to examine the warrant system for legal autopsy. The notion of warrant system is originated from concept of the due process of law guaranteed by the Constitution, and the warrant is a fundamental model to guarantee all human rights. But in the cases of legal autopsy, the Procedural Due process of Law about warrant is overemphasized and sometimes it hampers to find the substantial truth. Therefore, the author wants review the warrant system for legal autopsy and to propose the alternative method to replace the warrant for legal autopsy.
Autopsy* ; Civil Rights ; Constitution and Bylaws ; Human Rights ; Jurisprudence

The purpose of this thesis is to examine the warrant system for legal autopsy. The notion of warrant system is originated from concept of the due process of law guaranteed by the Constitution, and the warrant is a fundamental model to guarantee all human rights. But in the cases of legal autopsy, the Procedural Due process of Law about warrant is overemphasized and sometimes it hampers to find the substantial truth. Therefore, the author wants review the warrant system for legal autopsy and to propose the alternative method to replace the warrant for legal autopsy.
Autopsy* ; Civil Rights ; Constitution and Bylaws ; Human Rights ; Jurisprudence

Involuntary and compulsive admission can damage a patient's autonomy from a medicoethical aspect, but the patient who cannot understand information and explanations from a psychiatrist due to impaired judgment and lacks insight can have impaired judgment in certain circumstances. The decision making of a patient without substantial autonomy in a psychotic or intoxicated state can be justly neglected by the psychiatrist for the patient's sake. Compulsory admission is generally permitted only in case that a patient presents a danger to himself or others, which is not of a benefit to the patient not in danger because of the loss of the opportunity to take appropriate treatment. This enables psychiatrists not to abuse medical paternalism and to protect from the damage to patient's autonomy and civil right. Compulsive admission can be ethically justified to keep the principle of the least restrictive treatment and the patient's right to appropriate treatment. Psychiatrists should help enhance the patient's underestimated autonomy on the basis of the limited paternalism.
Civil Rights ; Decision Making ; Humans ; Judgment ; Paternalism ; Patient Rights ; Psychiatry

OBJECTIVES: The authors performed this survey to find out current status of petition and process for the extension of hospitalization of patients who were hospitalized more than 6 months. METHODS: Authors designed a questionnaire named 'Questionnaire for Survey of Current Status and Process of Petition for Extension of Hospitalization of Psychiatric Patients' and distributed it to 242 psychiatric facilities with closed wards for psychiatric patients. The psychiatric facilities includes 4 categories;psychiatric department of university hospital, psychiatric department of general hospital, psychiatric hospital and small sized private clinic. The period of survey was from Jan. 1 to Dec. 31 of 2002. RESULTS: Among 84 psychiatric facilities responded, 2,615 petitions for extension of hospitalization were submifted to the Local Mental Health Tribunal, and the dissent rate was 4.1%. The most of petitions were from psychiatric hospitals (2,265). The psychiatric departments of general hospitals favored the discharge-readmission method rather than applying extension by due process of the Mental Health Act when further admission was needed after 6 months hospitalization (280 vs. 106). The main reason for the petitions for extension of hospitalization was "no improvement" (72.7%) than "dangerousness to self or others" (14.7%). Against doctor's recommendation for discharge agter improvement, many patients couldn't be discharged becanse of guardians' refusal or cut off from caregiver or guardian. In cluded were these patients applied petitions for extension of hospitalization. CONCLUSION: This study suggests that hospitalization of some patients are extended improperly in view of the spirif of the Mental Health Act. The authors proposea new system of ambulatory treatment, reinforcement of psychiatric rehabilitation, legal control of the neglected patient by guardians.
Caregivers ; Civil Rights ; Dissent and Disputes ; Disulfiram ; Hospitalization* ; Hospitals, General ; Hospitals, Psychiatric* ; Humans ; Mental Health ; Patient Rights ; Surveys and Questionnaires ; Rehabilitation

OBJECTIVE: To investigate the disability identity and life satisfaction according to the severity of disability in the spinal cord injured persons resident in the community. METHOD: The subjects of this national wide study were 397 spinal cord injured persons resident in the community. We investigated their disability identity, life satisfaction, depression, social integration and social support. The questionnaire included the newly developed disability identity scale to evaluate the disability identity, that consisted of five sub-scales (personal worth, self-acceptance with the disabled, individual civil right, common cause and external barriers) and 23 questions. The subjects were divided into four groups according to severity of disability: motor complete tetraplegia, motor incomplete tetraplegia, motor complete paraplegia and motor incomplete paraplegia. RESULTS: The scores of life satisfaction, depression and social support were not different according the four groups. However the disability identity scale of the motor incomplete paraplegia was lower than motor complete tetraplegia or motor complete paraplegia (p<0.05). The sub-scale score of the personal worth and self-acceptance were lower in less severely disabled persons. As the disability identity scale was higher, social integration (r=0.478, p=0.000), and social support (r=0.465, p=0.000) were moderate and the depression was negative (r=-0.252, p=0.000). Conclusion: Less severely disabled persons showed lower disability identity. Disability identity scale was significantly correlated with higher social integration, higher social support and lower depression score. The newly developed disability identity scale will be a useful tool for the evaluation of the psychological status and planning the rehabilitation strategy for spinal cord injured persons.
Civil Rights ; Depression ; Disabled Persons ; Humans ; Paraplegia ; Quadriplegia ; Surveys and Questionnaires ; Spinal Cord ; Spinal Cord Injuries

The evaluation and management of the sexually assaulted women is a complex, multifaceted task. The purpose of the medical examination after a sexual assault is to assess the patient for physical injuries, and to collect evidence for forensic evaluation and possible legal proceedings. Laboratory samples should be obtained at the initial visit and should include testing for pregnancy, syphilis, and hepatitis B and human immunodeficiency virus infections. Treatment should address physical injuries, pregnancy prophylaxis, sexually transmitted diseases and psychosocial sequelae. Appropriate referral services should be initiated during the initial visit. Victims of sexual assault require appropriate care, follow-up, and information regarding their legal rights. The history should be confined to medically relevant facts and should be conducted in a safe and quiet environment. In many emergency departments, however, the emergency room doctors is responsible for the initial evaluation and management. Therefore, it is imperative that the emergency room doctors be familiar with the process and issues specific to the management of the victim of a sexual assault.
Civil Rights ; Emergencies ; Female ; Follow-Up Studies ; Hepatitis B ; HIV ; Humans ; Pregnancy ; Referral and Consultation ; Sexually Transmitted Diseases ; Syphilis

After a year of court trials initiated by the immediate family of a patient in a permanent vegetative state, the National Supreme Court of Korea ruled that the family have the right to decide for the removal of ventilator from the patient. This was a particularly significant court case that established a precedent for the Korean society as a whole, since there currently is no statutory framework regarding rights to self-determination to refuse any extraordinary means of treatment in Korean legal system. While much of Korean healthcare providers and the government itself have focused on designing and developing a comprehensive blueprint for Advance Health Directives for patients, the recent outcome has created an important opportunity for all parties of the Korean society. Therefore, the Korean government and legislature will need to systematically study and establish a procedural preparation for legislation. The providers will also have to carefully examine the moral and ethical dimensions of Advance Directives to promote the patients' interests in accordance with civil rights of the patients. Lastly and most importantly, the individuals must reflect on our own moral values, regardless of their current health. To exercise their own will and to relieve their relatives from difficult decisions, they must also educate themselves about living will and healthcare proxy, and elucidate their value history with family. No one can exactly lay out the course of life to death, but it is possible to steer the final journey of life to a more humane death. A society must value the life itself, but the journey to death should also be made humane by respecting one's own choice.
Advance Directives ; Civil Rights ; Delivery of Health Care ; Health Personnel ; Human Rights ; Humans ; Korea ; Living Wills ; Persistent Vegetative State ; Proxy ; Supreme Court Decisions ; Ventilators, Mechanical

Attitude to Health ; Civil Defense ; ethics ; Communicable Disease Control ; Communication ; Ethics, Medical ; Freedom ; Health Personnel ; ethics ; Health Planning ; ethics ; Health Priorities ; ethics ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; epidemiology ; Mandatory Programs ; ethics ; Moral Obligations ; Pandemics ; ethics ; Patient Rights ; ethics ; Primary Health Care ; ethics ; Public Health ; ethics ; Public Health Administration ; ethics ; Resource Allocation ; ethics ; Singapore ; Trust

OBJECTIVES: The Korean government has enacted two laws, namely, the Personal Information Protection Act and the Bioethics and Safety Act to prevent the unauthorized use of medical information. To protect patients' privacy by complying with governmental regulations and improve the convenience of research, Asan Medical Center has been developing a de-identification system for biomedical research. METHODS: We reviewed Korean regulations to define the scope of the de-identification methods and well-known previous biomedical research platforms to extract the functionalities of the systems. Based on these review results, we implemented necessary programs based on the Asan Medical Center Information System framework which was built using the Microsoft. NET Framework and C#. RESULTS: The developed de-identification system comprises three main components: a de-identification tool, a search tool, and a chart review tool. The de-identification tool can substitute a randomly assigned research ID for a hospital patient ID, remove the identifiers in the structured format, and mask them in the unstructured format, i.e., texts. This tool achieved 98.14% precision and 97.39% recall for 6,520 clinical notes. The search tool can find the number of patients which satisfies given search criteria. The chart review tool can provide de-identified patient's clinical data for review purposes. CONCLUSIONS: We found that a clinical data warehouse was essential for successful implementation of the de-identification system, and this system should be tightly linked to an electronic Institutional Review Board system for easy operation of honest brokers. Additionally, we found that a secure cloud environment could be adopted to protect patients' privacy more thoroughly.
Access to Information ; Bioethics ; Computer Security ; Electronics ; Electrons ; Ethics Committees, Research ; Ethics, Research ; Humans ; Information Systems ; Jurisprudence ; Masks ; Privacy ; Research Design ; Social Control, Formal ; Tertiary Care Centers