Issues on the Eligibility Management System in Medical Aid

The Ministry of Health and Welfare introduced a new reimbursement system called the Eligibility Management System in Medical Aid in July 2007. The operation of this system is interlocked with patient care programs of medical institutions. The new system was expected to realize effective management of the eligibility of beneficiaries by interactive communications between medical institutions and the National Health Insurance Corporation (NHIC) and thereby improve financial stabilization of the reimbursement system and optimize healthcare practices by preventing moral hazards in the relationship between beneficiaries and medical institutions. For the effective operation of this system, however, several drawbacks need to be resolved; firstly, one can currently use the system only through the internet, secondly, there is a legal issue that medical institutions are the subject of the management of eligibility, and lastly, healthcare information needs to be transferred to NHIC in a real-time manner. Particularly the last one needs a special attention because it can raise critical concerns of potential violation of human rights of patients and unnecessary regulations of medical practices.

A Case of Acute Aortic Regurgitation due to Non-traumatic Rupture of the Aortic Valve Commissure

Trauma and non-traumatic aortic pathologies such as infective endocarditis, syphilis, fenestrated aortic valves, valves with myxomatous transformation, cystic medionecrosis of the aorta, and inherited disorders of connective tissue may occasionally lead to a rupture of the aortic valve. Among the causes of the rupture of the aortic valve, the non-traumatic aortic valve commissural rupture is extremely rare. The aortic valve rupture typically results in a rapidly progressive heart failure and frequently, death. Therefore, early diagnosis is followed by an immediate operation is necessary. The purpose of this article is to report the first successful operation in Korea of a 44-year-old male patient with acute aortic regurgitation due to non-traumatic rupture of the aortic valve commissure.

Postprandial Blood Pressure Changes During Hemodialysis / 대한신장학회잡지

The effect of food consumption on blood pressure during hemodialysis was examined in relatively younger 10 nondiabetic patients with end stage renal disease who were free from autonomic dysfunction. A balanced diet(300 Cal) was given after 1 hour of hemodialysis. Fed and fasting treatments were randomly assigned, three times respectively, in each patient. Systolic(p=0.006), diastolic(p=0.08) and mean blood pressures fell faster in the 30-minute postprandial period in the fed treatments compared with those of equivalent times in the fasting treatments. For each of these changes, two-way repeated measures analysis of variance revealed neither significant time effect, nor significant treatment effect, nor significant interaction between time(before vs. after meal) and treatment(fed vs. fasting). These results suggest that food ingestion during hemodialysis dose not cause significant hypotension in relatively younger patients with end stage renal failure on chronic hemodialysis in the absence of autonomic dysfunction.