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      • KCI등재

        미국의 의료보험과 수가의 현황

        송문원(MW Song) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.2

        날로 발전하는 현대의학과 더부러 의료혜택의 범위도 날로 팽창하며, 그에 따르는 의료 비용 역시 상당한 증가를 보이고 있으며 그 의료비용을 감당키 위하여, Health Insurance는, 일상생활에 있어서 필수불가결의 조건으로 되어 있는 것이 오늘의 미국입니다. 의료보험이 오늘에 이르기까지의 경로와 실행되고 있는 보험의 종류를 조사 관찰하였고, 현재 의료인들의 수가 규정이 어떤 단계를 거쳐서 오늘에 이르렀으며 또 그 수가 규정을 실예를 들어서 관찰하고저 합니다. 이 수가 규정의 문제점, 아울러 나아가서 의료보험 자체의 문제점과 그 전망을 기술하겠습니다. Under private practice physician is free to charge his customary fee. The physician normally bills the patient for each service he has performed (such as office call, home visit, injection, or operation). In most cases elaborate lists of services, with a designated fee for each service, have been negotiated with the profession by the insurance system. Usually the negotiated fee represents the total that the physician can claim for the sevice, whether he makes his claim dircct to the insurer or whether he claims from the patient, who in turn is reimbursed in whole or part by the insurer. Under the fee-for-service system, the patient is free to choose and change his physician. This method has the advantage of paying practitioners according to services actually performed, but this system also provides practitioners with financial incentive to perform unnecessary or excessive services. the United States provides governmental health insurance program under the Social Security Act amendments of 1965, such as medicare(compulsory health insurance for the aged) and Medicaid(the program for the medically indigent). but most health insurance in the U.S. still consists of private health insurance programs. Much private health insurance in the U.S. is operated on a group basis, generally through groups of employees whose insurance payments may be subsidized by their employer. In 1956, Califonnia Medical Society completed a statewide survey of Fee Schedule through, 4,700 California pyhsicians after 3 years survey, forming "Relative Value Study"(Rvs). This Rvs has been used as a useful guide for physician, health insurances, government, throughout the country, for the last two decades. However, recently goverment agency, FTC(Federal Trade Commission) charged that Relative Value Study is "a price-fixing tool" and a violation against Anti-Trust Law, and therefore it is inflationary. Health care constitues the fastest growing major expenses of American consumers. The total annual cost of health care is estimated to be $115 billion, or 8% of the Gross National Product. Carter administration is preparing a wide comprehensiv NHI(National Health insurance) to put skyrising health care cost under control. The price of an average hospital expense has gone up form $350 in 1965 to $1,300 today. Average expense of normal delivery is about $1,000 and that of hysterectomy is over $2,500 to $3,000. High malpractice insurance premium causes fee increase and nationaly more than 50%, insurance cost was under $8,000 ; 35% paid $8,000-$15,000 and 13% had insurance costing over $15,000 and the highest rate is in California.

      • KCI등재

        과립막세포종 4예

        최종열(CY Choi),한백래(BN Hahn),송문원(MW Song),서영욱(YU Suh) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.4

        Recort was made on four cases of granulosa cell carcinoma in Korean females that were observed at the Department of Obstetrics and Gynecology. Presbyterian Hospital. Taegu. Korea. during the period of October. 1960, to May, 1964. The age incidence ranged from 33 to 44. with a parity range of 3 to 7. All of the four were unilateral, two being of diffuse form and the remaining folliculoid and cylindroid. respectively. Two out of the four showed luteinization. Three months after operation there was recurrence in one out of four granulosa cell tumors.

      • KCI등재

        광범한 문헌적 고찰을 중심으로한 Brenner 씨 종양

        서영욱(YU Suh),최종렬(JY Choi),노영하(YH Roh),송문원(MW Song) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.7

        Three cases of Brenner tumor among Korean women seen at the Department of Obstetrics and Gynecology, Presbyteian Hospital, Taegu, Korea, during the period through January, 1958 to March, 1966, are presented. The age incidence was over 48 years. Two of them were in the postmenopausal age group, being 52 and 67 years of age with a parity of 2 and 6 respectively, and the other, premenopausal being 48years of age with a parity of 6. In one of the cases, postmenopausal intermittent genital bleeding occurred. The tumor involvement was unilateral in all cases. Two of them were foung incidentally and were associated with other conditions such as leiomyoma and carcinoma in situ of cervix. In one case, the tumor occurred with a large mucinous cystadenoma. No speciflc clinical features which would lead to the preoperative diagnosis of Brenner tumor were obtained by reviewing the cases. There was no evidence of any endocrine activity or malignant changes of the tumor in any of the 3 cases. The follow-up study revealed no recurrence for as long as 1 month to 4 years. An attempt at extensive review of the literature on Brenner tumor is made in both clinicopathological and pathogenetic aspects.

      • KCI등재

        누출성난관유수종의 1예

        한병두(BD Han),서영욱(YU Suh),최종열(CY Choi),송문원(MW Song) 대한산부인과학회 1964 Obstetrics & Gynecology Science Vol.7 No.5

        1. 50세의 한국미임부에서 미분화배세포종의 전이로 인한 속발성 즉관암의 1예를 보고하였다. 2. 간헐적 수액루 혹은 hydrops tubae profluens가 원발성 혹은 속발성 난관암의 초기 및 특이증상임을 강조하였다. 3. Hydrops tubae profluens의 역사와 문헌적 고찰을 하였다. 1) A case of secondary carcinoma of the both tubes, metastatic by extension from dysgerminoma of the ovary which occurred in a 41 year old Korean woman is described. 2) The importance of intermittent hydrorrhoea or hydrops tubae profluens as an early and pathognomonic symptom has been stressed. 3) The history and literatures on Hydrops Tubae Profluens as a symptom in tubal carcinoma have been reviewed.

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