Ophthalmic plastic and orbital surgery in Taiwan.

We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery.

Operation Fee and Insurance Charge of Hallux Valgus Surgery / 대한족부족관절학회지

PURPOSE: The purpose of this study was to figure out the appropriate and systemic insurance charge for the hallux valgus operations. MATERIALS AND METHODS: 5 Hospitals for hallux valgus operations were analyzed how they have been charging the national health insurance corporation for their operation fees and how to use the estimated guide and authoritive interpretation through the guide book of health insurance medical treatment grant expense and the guide book of Health insurance medical treatment. RESULTS: There are nothing for guiding principle of hallux valgus operations in both books but a guide of Mcbride operation which is approved 'JA-93-KA and JA-31' for operation fee. So majority of hospitals have charged operation fee depending on their own interpretations they like. According to the guide books, there was a authoritive interpretation that simultaneous operation of osteotomy and tendon transfer for cerebral palsy and flat foot can be eatimated as 'osteotomy +JA-93-NA'. CONCLUSION: Distal soft tissue procedure should be approved as 'JA-93-NAx100%+JA-31x50%' according to the the estimated guide and authoritive interpretation if transected adductor hllucis is transfered to first metatarsal head. So distal chevron osteotomy could be 'JA-30-1-RAx100%+JA-31x50%', proximal metatarsal osteotomy could be 'JA-93-NAx100%+JA-31-50%+JA-30-1-RAx50%', first metatarsocuneiform joint arthrodesis could be 'JA-93-NAx100%+ JA-31x50%+JA-73-RAx50%'.

The Comparison of the Operation Fee among Taiwan, Japan, U.S.A. and Korea

PURPOSE: Under the national health insurance system, the price of surgical operation of Korea was thought low and unreasonable. The object of this study is to assess the adequateness of the operation fee of Korea. METHODS: We compared the operation fee of Korea with that of Taiwan, Japan and USA at the year of 2000. Compared items were selected according to incidence and importance in the 18 parts of surgery. The medical fee of USA is median price. RESULTS: Physical examination fee of USA is 6.7~34 times of that of Korea at the first visit and 4.9-38 times at the second visit. The fee of incision and drainage of Japan is 3.9 times of that of Korea and that of USA is 34.7~71 times of Korea. The appendectomy fee of Japan is 4.6 times of that of Korea and that of USA is 11.6 times of Korea. The sum of fee of 16 representative operations in surgery (I&D, suture of facial laceration, exision of benign skin tumor, lymphadenectomy, herniorrhaphy, hemorrhoidectomy, appendectomy, radical subtotal gastrectomy, radical mastectomy, thyroid lobectomy, cholecystectomy, splenectomy, right hemicolectomy, right hepatic lobectomy, whipple's operation, and striping of varicose vein) of Taiwan is 1.7 times of that of Korea, that of Japan is 7.3 times, and that of USA is 11 times (16.8 times at the highest price). CONCLUSION: There are big difference among these countries in the meaning of the price, the number of items and the price of the operations. The operation fee of Korea is relatively lower than that of other countires such as Taiwan, Japan and the USA.