Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Department of Emergency Medicine, Bundang Jesaeng Hospital, Daejin Medical Center, Seongnam, Korea.
J Korean Med Sci. 2020 Feb 24;35(7):e54. doi: 10.3346/jkms.2020.35.e54.
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.
床边超声（POCUS）是一种广泛应用于急诊和重症监护领域的有用工具。在韩国，自 2017 年至 2021 年，为增强韩国国家保险覆盖范围，陆续采取措施扩大超声检查的保险覆盖范围，这一举措将持续到 2021 年。2019 年 7 月，在急诊和重症监护领域全面实施了 POCUS 的健康保险全覆盖。《国家健康保险法》将 POCUS 归类为单一或多目标超声检查（STU 与 MTU）。STU 扫描每次仅对一个器官进行，而 MTU 包括同时对多个器官进行扫描以确定每个临床情况。根据医生的决定，即使进行了诊断性超声检查，也可以进行 POCUS。然而，健康保险审查和评估服务计划监测是否同时和重复开具 POCUS 和诊断性超声检查的处方情况。此外，仅在创伤、心脏骤停、休克、胸痛和呼吸困难的情况下允许进行 MTU，并且应由合格的医生进行。尽管医生在开具 MTU 时应扫描胸部、心脏和腹部的所有部位，但他们无需在病历中记录所有发现。因此，需要对 POCUS 进行适当的开具、应用和记录，以提高患者护理质量并避免不必要地削减医疗预算支出。本文基于韩国 2019 年 7 月开始全面实施 POCUS 健康保险覆盖范围的情况，为 POCUS 的实施提供背景和临床指导。
