• Journal of Korean Academy of Nursing
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• v.50 no.6
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• pp.837-847
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• 2020

Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.2
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• pp.131-139
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• 2022

Objectives This study aimed to analyze the medical utilization of low back pain (LBP) patients after back surgery and estimate the medical costs of Korean and Western medicine collaborative treatment, odds ratio, and hazard ratio between the two groups using the 2019 Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS-2019). Methods Data management and descriptive analysis, logistic regression, and survival analysis were conducted for defining and estimating the LBP patients after back surgery in the NPS 2019 dataset. Results A total of 216,424 patients out of 991,189 were identified as having LBP. Among the patients with LBP, 1,734 were treated with surgery while 214,690 were not. Among those who had surgery, 937 were treated with conventional treatments only and 797 underwent Korean medicine treatments. The odds ratio of the logistic regression analysis was 0.7129, suggesting that Korean medical treatment experience group had a 28.7% lower risk of reoperation than the Western medical treatments only group. The hazard ratio of the survival analysis was 0.9145; thus, the risk probability of reoperation was estimated to be approximately 8.55% lower. The 50% risk of reoperation was 69 days (0.5044) for the conventional group, and 97 days (0.5008) for the Korean medical group in the survival analysis using the Kaplan-Meier graph. Conclusions These results could be utilized in future studies in conducting economic evaluation for estimating cost-effectiveness of Western medicine and Korean medicine treatment compared to Western medicine alone in LBP patients after back surgery in a South Korean perspective. mended and should be applied while taking the necessary precautions.

• The Korean Society of Law and Medicine
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• v.22 no.4
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• pp.3-35
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• 2021

Inmitten der Flut der privaten und öffentlichen Information gilt die riesige Informationsmenge als Schlüsselressource im Zeitalter der 4. industriellen Revolution, repräsentiert durch Big-Data. Das Interesse an diesen wächst weltweit. Es gibt eine aktive Diskussion darüber, wie man Daten sichert und akkumuliert und wie man die gesammelten Daten sicher und effektiv nutzt. Gesundheitsdaten werden vor allem als die wertvollste Ressource bewertet, für die Big-DataTechnologie eingesetzt wird. Um Gesundheitsdaten sinnvoll zu nutzen, müssen verteilte Gesundheitsdaten integriert und den Benutzern in einer Form zur Verfügung gestellt werden, die für Forschung oder Inspektion verwendet werden kann. In einer Situation, in der große Länder um den Aufbau bzw. die Führung der Datenwirtschaft konkurrieren, wurden im August 2020 auch in Südkorea die sog. „3-Daten-Gesetze" geändert, die das Datenschutzgesetz(DSG) enthälten. Das DSG führte das Konzept der pseudonymen Informationen ein und baute eine Rechtsgrundlage für deren Verwendung auf. Als Folgemaßnahme kündigte die, Kommission für den Schutz personenbezogener Daten(Personal Information Protection Commission: PIPC)' die „Richtlinien für die Bahandlung mit pseudonymen Informationen" und, Ministerium für Gesundheit und Wohlfahrt' die „Richtlinien für die Verwendung von Gesundheitsdaten" an. Gesundheitsdaten stehen direkt in Zusammenhang mit Leben und Körper des Menschen und damit enthalten viele sensible Daten. Es handelt sich also um ein System, das aus einer vorsichtigeren und konservativeren Sicht unter der Voraussetzung verwendet werden kann, personenbezogene Daten sicherer zu schützen. Um die Hauptinhalte der „Richtlinien für Verwendung von Gesundheitsdaten" zu analysieren, überprüften wir zunächst die Hauptinhalte des überarbeiteten DSG. Danach durch die Analyse der wesentlichen Inhalte der „Richtlinien für Verwendung von Gesundheitsdaten" wurden Probleme wie Konflikte mit anderen Gesetzen und Verbesserungsmaßnahmen überprüft.

• 한국노년학
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• v.29 no.1
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• pp.37-50
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• 2009

The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

• Journal of Cadastre & Land InformatiX
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• v.47 no.1
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• pp.267-276
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• 2017

Damages have occurred in various fields such as agriculture, industry, and citizen's health due to the yellow dust. Therefore, it is urgent to take measures against it. In this regard, this study collected data of yellow dust over 11 days on a basis of Feb. 23. 2015 when yellow dust was the greatest after 2009, issue words analysis and recomposed health related tweet data. After testing the significance of yellow dust related diseases by association rule analysis with diseases, it obtained the study results as follows: As a result of significance test for the patients with rhinitis, asthma and conjunctivitis by acquiring the condition data of patients from the Health Insurance Review & Assessment Service, conjunctivitis appeared to be significant in 13 cities for 16 cities at 5% significance probability, while asthma and rhinitis showed a significance in 3 and 6 areas. As described above, it is possible to obtain information about citizens' health from SNS data, such as Tweet data and it is judged that these data will provide useful information for establishing measures of citizens' health care.

• The Journal of the Korea Contents Association
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• v.14 no.10
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• pp.562-569
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• 2014

The purpose of this study was to investigate the determinants of total payment for mental and behavioral disorders patients admitted through the emergency room. Study data was selected from the Korean National Health Insurance sample data in 2009. This data was consisted of 753 inpatients who are 331 inpatients with only main sick(F31-F39) and 422 inpatients with main sick codes(F31-F39) and sub sick(F00-F99) admitted through the emergency room. SPSS v.18 was used for the statistical analysis such as descriptive analysis, t-test, ANOVA, and multiple regression analysis. In multiple regression analysis, significant variables affecting total payment of main sick patients were gender(p<.01), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). Also, main sick patients with sub sick were gender(p<.01), age(p<.001), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). These findings implied that it is necessary to build short, middle, and longterm program and system for high risk mental and behavioral disorders groups.

• The Journal of the Korea Contents Association
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• v.19 no.3
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• pp.365-374
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• 2019

Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.38-52
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• 2021

Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.977-986
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• 2008

Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.