• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.215-230
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• 2005

The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.

• Korean Journal of Social Welfare Studies
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• v.44 no.3
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• pp.421-450
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• 2013

One of the challenging tasks of the National Health Insurance Corporation(NHIC). the only public insurance institution administrating the Korea's compulsory national health insurance(NHI) system, is to make those NHI beneficiaries who fail to make a scheduled monthly premium payment to pay. For this purpose, the NHIC has been using a measure known as 'Benefit Limit Measure(BLM)' in which those who miss premium payment for six or more month's in total are classified as 'late payer' and are sent warnings and late payer status notices. If the late payers fail to make a full payment of missed premiums even after receiving the written notices, the NHIC can order a temporary seizure of the late payer's property until all missed premiums plus interest are paid. Recently, the BLM has been criticized by the public of its cruel nature, and its effectiveness has been questioned because no empirical evidence has been collected. In this study, the authors using the NHIC data set attempted to analyze the effectiveness of the BLM. Those late payers for whom the BLM was administered were compared to those not in terms of the likelihood of paying missed premium payments with a series of logistic regression analyses models. Data analyses results showed that the likelihood of paying one or more month's unpaid premium of the former group was 14 to 46 times higher than the latter. It, however, was also found that the BLM was only effective to make no more than 12% of the late payers to pay at all. Based on the study findings, the authors made a few recommendations regarding the BLM.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1024-1037
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• 2020

The resource-based relative value scale (RBRVS) compares the value of a medical practice to the consumption of resources, which consist of the work of the physician, practice expenses, and professional liability insurance. At the time of the 2nd revision of RBRVS, the fee for radiological examinations had been reduced due to the high preservation rate. In RBRVS, practice expenses account for most of the compensation of radiological examinations, and physicians' work is relatively undervalued. A new healthcare policy (Moon Jae-In care) consists of the expansion of the National Health Insurance (NHI) coverage, reduction of patient charges for the vulnerable class, and support for catastrophic medical expenses. However, Moon Jae-In care is expected to negatively affect the NHI in Korea financially. The expansion of the insurance coverage for ultrasonography and MRI examinations is a significant part of the Moon Jae-In care, and radiological societies should establish fair compensations for physicians' work within the field of radiology while implementing the Moon Jae-In care.

• Journal of dental hygiene science
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• v.15 no.6
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• pp.768-774
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• 2015

The purpose of this study was to grasp the benefits from pit and fissure sealants and to analyze the factors of influencing the benefit amount by using the raw data of the Korea National Health and Nutrition Examination Survey for 2007~2013 targeting the subjects aged from 6 years in full to 18 years. The analysis was used STATA 11.0. As a result of the analysis, the following conclusions were obtained. It rose up to 1.24 pieces after carrying out the national health insurance coverage from averagely 0.93 piece until the year in 2007~2009 (up to November) when is before enforcing the national health insurance coverage in the pit and fissure sealants. The benefits from pit and fissure sealants depending on general characteristics were surveyed to be higher in the higher income level, in the more subscription to health insurance and private insurance, and in the more toothbrushing frequency per day. The factors that have influence upon the benefits from pit and fissure sealants were shown to include whether or not to have the national health insurance coverage in the pit and fissure sealants, income level, health insurance type and private insurance subscription appearance, and one-day toothbrushing frequency. Synthesizing the results, a rise in the benefits from pit and fissure sealants is shown in 2010 based on December 2009 when the national health insurance coverage in the pit and fissure sealants was implemented, but is showing the tendency of declining again from 2011. To increase the benefits from pit and fissure sealants, it is thought that the schemes will need to be discussed such as reinforcing publicity on the national health insurance coverage in the pit and fissure sealants, expanding a support for low-income bracket, and differentiating the outpatient cost sharing according to socio-economic level.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1083-1095
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• 2020

Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.

• Journal of the Korean hospital association
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• v.34 no.1 s.293
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• pp.114-116
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• 2005

• Journal of the Korean Catholic Hospital Association
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• v.32
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• pp.5-23
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• 2002

• The Monthly Diabetes
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• s.259
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• pp.68-69
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• 2011

최근 보건복지부에서 '당뇨병용제 개정안'을 행정예고 하여 논란이 되고 있다. 건강보험 재정 안정화를 위해 발표된 이번 개정안을 두고 대한의사협회에서 당뇨병용제 급여기준에 대해 정부의 의도를 지적하고 나섰다. 이로 말미암아 복지부와 의사협회와의 대립이 고조되면서 긴장감이 흐르고 있다.

• Korean Journal of Social Welfare Studies
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• v.41 no.2
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• pp.35-65
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• 2010

The purpose of this study is to identify the relationship between health insurance and health by evaluating the impacts of health insurance coverage expansion on health care utilization and health status. To analyze the causal relationship between health insurance and health, this study employed a "difference-in-difference method" that could compare changes in health care utilization and health status across groups in health insurance coverage expansion in 2005. The researcher predicted that the expansion of health insurance coverage would be an exogenous source of variation in the prices of health service use. First, the difference-in-differences estimator between 'illness group' and 'non-illness group' revealed that the increase in coverage of inpatient care services would result from the increases in the stay of length of 'non-illness group' rather than that of 'illness group'. However, the difference-in-differences estimator between 'serious illness group' and 'chronic illness group' identified that the policy change that focuses on expansion of the coverage for 'serious illness' effects on the increases in health care utilization and promotion of health status. In summary, the changes of health insurance coverage focusing on serious illness and inpatient care have positive effects on health care utilization and health status of serious illness group. But, 'non-illness groups' with acute illness receive more benefits from the policy change than 'illness group' with chronic illness.

• The Journal of the Korea Contents Association
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• v.15 no.10
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• pp.374-386
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• 2015

This study attempts to examine the impact of a documentary film, on the perception and satisfaction with the public health insurance system in South Korea. It is needed that public support to expand health insurance coverage and to intensify national health insurance. The documentary film investigates health care in the United States, comparing with the non-profit universal health care systems of Canada, the United Kingdom, France and Cuba. So an online education content for the general education was developed using this film and the surveys were carried out to gather information about perception, satisfaction and opinion on national health insurance system before the lesson and after. And pared t tests were conducted to analyze the effects of this education content using the film on perception and attitudes towards national health insurance system. Based on the empirical results, the way to develop education contents for improving the understanding public health system and to verify the effect of education contents were discussed.