• Title/Summary/Keyword: 건강보험제도

Search Result 184, Processing Time 0.03 seconds

Principles and Conceptual Framework for the Introduction of Korean Sickness Benefit (한국형 상병수당 도입을 위한 제도 설계의 원칙과 개념적 틀)

  • Kang, Hee-Chung
    • Health Policy and Management
    • /
    • v.31 no.1
    • /
    • pp.5-16
    • /
    • 2021
  • Both access to healthcare services and income security in case of personal illness are being needed to achieve universal health coverage, which is enshrined in the human rights to health and social security and international standards on social protection. Income security acts on both the social determinants and the adverse consequences of ill health and thus would break the vicious disease-poverty cycle. The government is supposed to implement a demonstration project of sickness benefit in 2022 and to publicize its more specific blueprint for all workers. This study is to suggest basic principles and a framework to design a new sickness benefit for universal health coverage, which is based on reviews on previous studies, related issues, and institutional conditions. This is to provide a theoretical basis to promote further discussion and to support its decision-making.

A suggestion of health insurance for children (소아 영역의 건강보험제도 개선안)

  • Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.4
    • /
    • pp.339-342
    • /
    • 2008
  • The Korean Health Insurance (KHI) has been introduced since 1977 and it took only 12 years that KHI had accomplished the total coverage of Korean population. The remarkable success of KHI can be compared with other OECD countries which had taken some 30 years to over 100 years to establish the total coverage of the population. Life expectancy at birth and the infant mortality rate in Korea in 2005 both surpassed the average figures of the OECD countries, The main reason for the success of KHI can be delineated with the three characteristics in KHI development; low premiums, low benefits, and low fee-schedule charges. However, these three characteristics of KHI, which had been the key for the rapid development of the system, have become terrible disadvantages for the stable development of KHI. The dissatisfaction and discontent of health care providers are ever increasing. The population is reluctant to pay more premiums though it seems essential for the better care coverage. The health care system has been heavily distorted toward high technology-oriented expensive care. There should be several factors seriously tackled for the secure development of KHI in the future. This paper will review a brief history of KHI development, and I would like to make a suggestion of health insurance for children.

The effects of the implementation of long-term care insurance on the quality of life trajectory among older adults with disabilities (노인장기요양보험제도의 시행이 장애노인의 삶의 질 궤적에 미치는 영향)

  • Jeon, Hae Sook
    • Korean Journal of Health Education and Promotion
    • /
    • v.32 no.3
    • /
    • pp.97-107
    • /
    • 2015
  • Objectives: The current study aims to examine whether the influence of National Long-term Care Insurance(NLCI) on the quality of life(QoL) trajectory of older adults with disabilities is more positive than its influence on those without disabilities. Methods: Sample consisted of 5,362 elderly aged 65 and over who participated in the Korean Welfare Panel Study from Wave1 to Wave7. Data were analyzed using latent growth curve modeling. Results: Major findings are as follows. (1) Before the NLCI, the trajectories of QoL between older adults with disabilities and those without were same. (2) After the NLCI, elders with disabilities showed lower levels of QoL at the beginning, but the gaps gradually decreased with time. These results indicate that the implementation of NLCI more positively affected elders with disabilities than those without disabilities. Conclusions: These results suggest that the NLCI functions properly as one of social security nets to cope with the needs of older adults with disabilities. In conclusion, it is critical to develop a sustainable NLCI system to enhance the QoL of older adults with disabilities.

Restructuring the Decision Making Process for the Korea National Health Insurance System (건강보험제도 정책수립과정의 재설계에 대한 모색)

  • Kang, Min Ah;Kim, Tae-Il;Huh, Soon-Im
    • Health Policy and Management
    • /
    • v.18 no.2
    • /
    • pp.107-129
    • /
    • 2008
  • The purpose of this paper is to critically examine Korean government's efforts in policy making and implementation regarding the Korea National Health Insurance System in the past and suggest a new paradigm for future policy changes. The structural and political characteristics of the Korea National Health Insurance, where health care services are provided almost exclusively by the private providers and funding for health comes equally from public and private sources, imply persistent difficulties in the operation of the system This may partially explain why the Korean system has continually experienced conflicts among stakeholders whenever there was an attempt to change policy. In this paper, we discuss four cases to illustrate such difficulties and barriers. We propose that in order to address these challenges and reduce policy errors as well as unintended results, it is necessary to restructure policy making process from being oriented toward 'quantitative expansion' to 'qualitative maturity', from a 'linear thinking' to a 'system thinking', from taking a 'top-down' to a 'governance and participatory' decision making process.

Comparative analysis of health insurance system and dental hygiene curriculum for 3 years (치위생학 교과의 3년간 건강보험제도 반영 비교 분석)

  • Choi, Hyo-Jin;Oh, Sang-Hwan
    • Journal of Korean Academy of Dental Administration
    • /
    • v.8 no.1
    • /
    • pp.37-40
    • /
    • 2020
  • The background of this study is the observation that there is an increase in the number of elderly persons and the decrease in fertility rates, which may be related to the increase in the average age of the Korean people; accordingly, the national health insurance system changes every year following this pattern. However, this study investigates whether these changes are reflected in the dental hygiene curriculum. Data from the national health insurance system is reviewed for the last three years, and the recently published dental hygiene curriculum is selected, compared, and analyzed using a literature survey. The study is divided into two parts: information that is reflected in the dental hygiene curriculum and information that is not reflected in the dental hygiene curriculum, but which it is believed should be included. In addition, as the part reflected in the dental hygiene curriculum, it was stated in three subjects of dental implantology, dental prosthesis, and conservative dentistry, and there were four cases. Therefore, efforts should be made to ensure that the curriculum for dental hygiene students should reflect the changes in the national health insurance system so that students can more easily understand dental insurance claim processes.

Hospital-based home care reinbursement and service use for the elderly (노인의 의료기관 가정간호 급여청구 및 서비스 이용 현황)

  • Chin, Young-ran
    • 한국노년학
    • /
    • v.29 no.2
    • /
    • pp.645-656
    • /
    • 2009
  • The purpose of this study was to address the current status of hospital-based home care(HBHC). We analyzed the data on HBHC from national electronic data information of Health Insurance Review Agency. Beside, we surveyed 75 hospital-based home care agency. In 2006, 20,343 elderly(64.0% from all HBHC user) used 333,889 visits(76.8%from all visits). Medical diagnosis was composed of circulatory disease including cerebrovascular diseases 41.3%, endocrine system disease including Diabetes mellitus 10.4%, neoplasm 9.7%. Some of subjects used HBHC in excess of maximum covered 8 visits a month by National Health Insurance, decubitus 7.0%, the cancer 5.4%, the diabetes 2.5%, the hypertension 1.1%, and the stroke 0.9%. This results will contribute to expand the coverage of hospital-based home care by National Health Insurance. There was distribution difference in medical diagnosis and nursing intervention between HBHC and Public health center-based home care(PBHC) subjects. Therefore, HBHC subjects had more severe medical diagnosis, and were intervened more injections, examinations, than PBHC subjects. These differences must be considered to set up functional role among the three types of home visit care.

Prerequisites for Activation of Telemedicine (원격의료 활성화를 위한 선결과제)

  • Jeon, Young-Ju
    • Journal of the Korea Society of Computer and Information
    • /
    • v.19 no.8
    • /
    • pp.169-176
    • /
    • 2014
  • The rapid development of the current information and communication brings big changes and progress in the health service delivery system. And it is becoming the worldwide trend increasingly. In order to implement established what policy peacefully is sufficient review and dialogue, social consensus are integral components. The government in the telemedicine services, health care industry that is directly related to the public health and development spheres as nations of the society which to vote on new growth policy is a great social health policies of the push ahead with an unconditional side effects. But before it was activated, telemedicine, which is capable of ensuring the health and lives of the people in need of revision of the safety and effectiveness of any kind, and enforces a stretch enough before review and social consensus, must necessarily be a prerequisite. In conclusion, it presently appears to be inappropriate and impossible to conduct telemedicine system through the foreign of telemedicine. It suggested to present the problems on telemedicine in korea.

Occupational Therapy in Long-Term Care Insurance For the Elderly Using Text Mining (텍스트 마이닝을 활용한 노인장기요양보험에서의 작업치료: 2007-2018년)

  • Cho, Min Seok;Baek, Soon Hyung;Park, Eom-Ji;Park, Soo Hee
    • Journal of Society of Occupational Therapy for the Aged and Dementia
    • /
    • v.12 no.2
    • /
    • pp.67-74
    • /
    • 2018
  • Objective : The purpose of this study is to quantitatively analyze the role of occupational therapy in long - term care insurance for the elderly using text mining, one of the big data analysis techniques. Method : For the analysis of newspaper articles, "Long - Term Care Insurance for the Elderly + Occupational Therapy for the Elderly" was collected after the period from 2007 to 208. Naver, which has a high share of the domestic search engine, utilized the database of Naver News by utilizing Textom, a web crawling tool. After collecting the article title and original text of 510 news data from the collection of the elderly long term care insurance + occupational therapy search, we analyzed the article frequency and key words by year. Result : In terms of the frequency of articles published by year, the number of articles published in 2015 and 2017 was the highest with 70 articles (13.7%), and the top 10 terms of the key word analysis showed the highest frequency of 'dementia' (344) In terms of key words, dementia, treatment, hospital, health, service, rehabilitation, facilities, institution, grade, elderly, professional, salary, industrial complex and people are related. Conclusion : In this study, it is meaningful that the textual mining technique was used to more objectively confirm the social needs and the role of the occupational therapist for the dementia and rehabilitation in the related key keywords based on the media reporting trend of the elderly long - term care insurance for 11 years. Based on the results of this study, future research should expand research field and period and supplement the research methodology through various analysis methods according to the year.

Study on Needs and Satisfaction of Service Related to Assistive Device and Assistive Device for Long-Term Care Elderly : Focused on Beneficiary Older Adults People in Long-term Care Insurance (노인복지용구의 품목 및 서비스의 만족도와 요구도에 대한 연구:노인장기요양보험 등급 인정자를 중심으로)

  • Woo, Ji-Hee
    • The Journal of the Korea Contents Association
    • /
    • v.19 no.9
    • /
    • pp.348-356
    • /
    • 2019
  • This study is was to suggest improvement of assistive device for the elderly according to investigate the satisfaction and the needs of assistive device for elderly. The subjects were 184 beneficiary older adults in long-term health insurance who used home care service in I city and D city. Data were analyzed using SPSS 20.0. With the exception of cognitive assistance grade, subjects were showed from 'normal' to ' satisfied' on a types of assistive device and services related to assistive device. I, II grade subjects needed assistive device for self-care. III, IV and V grade subjects needed assistive device for safety and health maintenance. In the service related assistive device, All subjects needed service on 'periodic follow-up service', 'expert on assistive device' and 'comprehensive evaluation'. This results is significant in that it suggest to needed assistive device in accordance with grade unlike previous studies. Results of this study will expected to utilize as a basic evidence for improvement of assistive device, service related to assistive device for elderly.

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
    • /
    • v.8 no.2
    • /
    • pp.89-99
    • /
    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.