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Current status and comparison of national health insurance systems for advanced radiation technologies in Korea and Japan

Radiation Oncology Journal 2020년 38권 3호 p.170 ~ 175
허승재, Nishimura Tetsuo, 박원, Onishi Hiroshi, 안용찬, Nakamura Katsumasa,
소속 상세정보
허승재 ( Huh Seung-Jae ) - Health Insurance Review and Assessment Service Department of Healthcare Review and Assessment
 ( Nishimura Tetsuo ) - Shizuoka Cancer Center Hospital Radiation and Proton Therapy Center
박원 ( Park Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
 ( Onishi Hiroshi ) - University of Yamanashi Department of Radiology
안용찬 ( Ahn Yong-Chan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
 ( Nakamura Katsumasa ) - Hamamatsu University School of Medicine Department of Radiation Oncology

Abstract


Purpose: This study aimed to compare the current status of the national health insurance system (HIS) for advanced radiation technologies in Korea and Japan.Materials and methods: The data of the two nations were compared according to the 2019 guidelines on the application and methods of medical care benefit from the Ministry of Health and Welfare of Korea and the 2020 medical fee points list set by the Ministry of Health, Labor and Welfare of Japan.

Results: Both countries have adopted the social insurance system and the general payment system which is fee-for-service for radiotherapy. However, for proton and carbon ion therapy, the Japanese system has adopted a bundled payment system. Copayment for radiotherapy is 5% in Korea and 30% (7?69 years old) in Japan, with a ceiling system. A noticeable difference is that additional charges for hypofractionation, tele-radiotherapy planning for an emergency, tumor motion-tracking, purchase price of an isotope, and image-guided radiotherapy are allowed for reimbursement in the Japanese system. There are some differences regarding the indication, qualification standards, and facility standards for intensity-modulated radiation therapy, stereotactic body radiation therapy, and proton therapy.

Conclusion: Patterns of cancer incidence, use of radiotherapy and infrastructure, and national HIS are very similar between Korea and Japan. However, there are some differences in health insurance management systems for advanced radiation technologies.

키워드

National health insurance; Intensity-modulated radiation therapy; Stereotactic body radiation therapy; Proton therapy; Korea; Japan

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