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

• Choi WJ
• Ha YR
• Oh JH
• Cho YS
• Lee WW
• Sohn YD
• Cho GC
• Koh CY
• Do HH
• Jeong WJ
• Ryoo SM
• Kwon JH
• Kim HM
• Kim SJ
• Park CY
• Lee JH
• Lee JH
• Lee DH
• Park SY
• Kang BS

• KMID: 2470780
• DOI: http://doi.org/10.3346/jkms.2020.35.e54

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

MeSH Terms

Abdomen
Budgets
Chest Pain
Critical Care*
Dyspnea
Emergencies*
Heart
Heart Arrest
Insurance Coverage*
Insurance*
Insurance, Health
Korea*
Medical Records
National Health Programs
Patient Care
Point-of-Care Systems*
Prescriptions
Shock
Thorax
Ultrasonography*