J Korean Med Sci.  2020 Feb;35(7):e54. 10.3346/jkms.2020.35.e54.

Clinical Guidance for Point-of-Care Ultrasound in the Emergency and Critical Care Areas after Implementing Insurance Coverage in Korea

Affiliations
  • 1Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 2Department of Emergency Medicine, Bundang Jesaeng Hospital, Daejin Medical Center, Seongnam, Korea. youngrock.ha@gmail.com
  • 3Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 4Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • 5Department of Emergency Medicine, Seongnam Citizens Medical Center, Seongnam, Korea.
  • 6Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
  • 7Department of Emergency Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
  • 8Department of Emergency Medicine, Dankook University College of Medicine, Cheonan, Korea.
  • 9Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
  • 10Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea.
  • 11Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 12Department of Emergency Medicine, Bundang CHA Hospital, CHA University School of Medicine, Seongnam, Korea.
  • 13Department of Emergency Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
  • 14Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Korea.
  • 15Department of Trauma Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea.
  • 16Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 17Department of Emergency Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
  • 18Department of Pulmonology and Intensive Care Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
  • 19Department of Emergency Medicine, Yeungnam University Medical Center, Daegu, Korea.
  • 20Department of Emergency Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

Abstract

Point-of-care ultrasound (POCUS) is a useful tool that is widely used in the emergency and intensive care areas. In Korea, insurance coverage of ultrasound examination has been gradually expanding in accordance with measures to enhance Korean National Insurance Coverage since 2017 to 2021, and which will continue until 2021. Full coverage of health insurance for POCUS in the emergency and critical care areas was implemented in July 2019. The National Health Insurance Act classified POCUS as a single or multiple-targeted ultrasound examination (STU vs. MTU). STU scans are conducted of one organ at a time, while MTU includes scanning of multiple organs simultaneously to determine each clinical situation. POCUS can be performed even if a diagnostic ultrasound examination is conducted, based on the physician's decision. However, the Health Insurance Review and Assessment Service plans to monitor the prescription status of whether the POCUS and diagnostic ultrasound examinations are prescribed simultaneously and repeatedly. Additionally, MTU is allowed only in cases of trauma, cardiac arrest, shock, chest pain, and dyspnea and should be performed by a qualified physician. Although physicians should scan all parts of the chest, heart, and abdomen when they prescribe MTU, they are not required to record all findings in the medical record. Therefore, appropriate prescription, application, and recording of POCUS are needed to enhance the quality of patient care and avoid unnecessary cut of medical budget spending. The present article provides background and clinical guidance for POCUS based on the implementation of full health insurance coverage for POCUS that began in July 2019 in Korea.

Keyword

Point-of-Care Systems; Ultrasonography; Insurance; Insurance Coverage; Emergencies; Critical Care
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