• Title/Summary/Keyword: 국민건강보험

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Influencing Factors to Enrollment in Private Health Insurance and Medical Use by Life Cycle : Analysis of 2016-2019 Korea Welfare Panel (생애주기별 민간의료보험 가입 영향 요인 및 의료이용 행태 : 2016~2019년 한국복지패널자료를 사용하여)

  • Kim, Ji-On
    • Journal of Convergence for Information Technology
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    • v.11 no.10
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    • pp.194-204
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    • 2021
  • This study was conducted to find out the status and factors of private health insurance subscriptions by life cycle and to identify differences in medical usage behavior by life cycle. Using the SPSS 26 program as the 12th-15th (2016-2019) data of the Korea Welfare Panel, the difference subscriptions was identified as Chi-square by demo social and health characteristics of 58,223 people, and the factors affecting subscription were analyzed by polynomial logistic analysis and average analysis was performed for medical use behavior. As a result of the analysis, the biggest factor in purchasing private health insurance was household income, private health insurance coverage is the highest in growth period, and multiple subscriptions were made depending on household income. In youth, household income, spouse, and no disability, and middle age, household income, economic activities, spouses, and health levels were largely influential factors. The rate of private health insurance coverage in old age was the lowest, and low-income households, poor health levels, and people with disabilities were lower. The increase in medical use by private health insurance subscribers also occurred during growth and youth. It is necessary to strengthen the national health insurance coverage, and the role of private health insurance to supplement it should be established in time for the life cycle to complement each other, eliminating blind spots of medical security and maximizing people's health and well-being.

A recommendation system for assisting devices in long-term care insurance (의사결정나무기법을 활용한 장기요양 복지용구 권고모형 개발)

  • Han, Eun-Jeong;Park, Sanghee;Lee, JungSuk;Kim, Dong-Geon
    • The Korean Journal of Applied Statistics
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    • v.31 no.6
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    • pp.693-706
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    • 2018
  • It is very important to support the elderly with disability ageing in place. Assisting devices can help them to live independently in their community; however, they have to be used appropriately to meet care needs. This study develops an assisting device recommendation system for the beneficiaries of long-term care insurance that include algorithms to decide the most appropriate type of assisting device for beneficiaries. We used long-term care (LTC) insurance data for grade assessment including 8,084 beneficiaries from July 2015 to June 2016. In addition, we collected standard care plans for assisting devices, that power-assessors made, considering their performance and ability that could subsequently be matched with grade assessment data. We used a decision-tree model in data-mining to develop the model. Finally, we developed 15 algorithms for recommending assisting devices. The findings might be useful in evidence-based care planning for assisting devices and can contribute to enhancing independence and safety in LTC.

보건교육사 양성 프로그램 개발

  • Kim, Cho-Kang;Kim, Myung;Koh, Seung-Deok;Kim, Yeong-Bok
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 1998.07a
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    • pp.81-97
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    • 1998
  • 국민들의 생활수준향상 및 질병양상의 변화 등으로 건강에 대한 관심이 증대됨에 따라 지역사회 뿐만 아니라 의료보험관리공단 및 의료보험조합에서도 각종 만성퇴행성질환에 대한 사전예방을 통하여 국민의 건강증진을 꾀하고 삶의 질을 향상시킴으로써 의료비 지출을 절감시킬 수 있는 보건예방사업을 전개하기 시작하였다. 이는 예방이 치료보다 10배 정도의 비용절감효과를 가져오기 때문이다.

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Incidence of Falls and Risk Factors of Falls in Inpatients (입원환자의 낙상 실태 및 위험요인 조사연구)

  • Yoon, Soo-Jin;Lee, Chun-Kyon;Jin, In-Sun;Kang, Jung-Gu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

A Taxonomy of Geriatric Hospitals Using National Health Insurance Claim Data (건강보험청구자료로 본 요양병원의 기능 유형)

  • Min Kyoung Lim;Sun-Jea Kim;Jeong-Yeon Seon
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.9-20
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    • 2023
  • Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

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Development of prediction model identifying high-risk older persons in need of long-term care (장기요양 필요 발생의 고위험 대상자 발굴을 위한 예측모형 개발)

  • Song, Mi Kyung;Park, Yeongwoo;Han, Eun-Jeong
    • The Korean Journal of Applied Statistics
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    • v.35 no.4
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    • pp.457-468
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    • 2022
  • In aged society, it is important to prevent older people from being disability needing long-term care. The purpose of this study is to develop a prediction model to discover high-risk groups who are likely to be beneficiaries of Long-Term Care Insurance. This study is a retrospective study using database of National Health Insurance Service (NHIS) collected in the past of the study subjects. The study subjects are 7,724,101, the population over 65 years of age registered for medical insurance. To develop the prediction model, we used logistic regression, decision tree, random forest, and multi-layer perceptron neural network. Finally, random forest was selected as the prediction model based on the performances of models obtained through internal and external validation. Random forest could predict about 90% of the older people in need of long-term care using DB without any information from the assessment of eligibility for long-term care. The findings might be useful in evidencebased health management for prevention services and can contribute to preemptively discovering those who need preventive services in older people.

Covered Self-expandable Metallic Stent Insertion as a Rescue Procedure for Postoperative Leakage after Primary Repair of Perforated Duodenal Ulcer (십이지장 궤양 천공 단순 봉합수술 후 완전 피막형 자가확장 금속 스텐트 삽입술로 치료된 봉합 부위 누출)

  • Yoo, Young Jin;Lee, Yong Kang;Lee, Joong Ho;Lee, Hyung Soon
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.262-266
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    • 2018
  • Surgery has been the standard treatment for perforated duodenal ulcers, with mostly good results. However, the resolution of postoperative leakage after primary repair of perforated duodenal ulcer remains challenging. There are several choices for re-operation required in persistent leakage from perforated duodenal ulcers. However, many of these choices are complicated surgical procedures requiring prolonged general anesthesia that may increase the chances of morbidity and mortality. Several recent reports have demonstrated postoperative leakage after primary repair of a perforated duodenal ulcer treated with endoscopic insertion using a covered self-expandable metallic stent, with good clinical results. We report a case with postoperative leakage after primary repair of a perforated duodenal ulcer treated using a covered self-expandable metallic stent.

The Septic Knee Arthritis Caused by Klebsiella pneumoniae in a Patient with Type 2 Diabetes Mellitus and Osteoarthritis of the Knee (제2형 당뇨 및 골관절염을 동반한 환자에서 발생한 Klebsiella pneumoniae균에 의한 화농성 관절염)

  • Ha, Joong-Won;Lee, Sanghyeon;Park, Sang-Hoon;Kim, Tae-Yup
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.67-71
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    • 2019
  • Klebsiella pneumoniae causes that liver abscess mostly, also spread to pneumonia, meningitis, urinary tract infections. Septic arthritis caused by K. pneumoniae is a quite rare and has not been reported in Korea. Therefore, the authors report a case of the septic arthritis in the knee joint caused by K. pneumoniae in a patient with type 2 diabetes mellitus and osteoarthritis of the knee that successfully treated by early detection and arthroscopic synovectomy.

Fighting hiteen~ - 10대도 안심할 수 없는 위염 그 증상과 치료법은?

  • Lee, Haeng-Rim
    • 건강소식
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    • v.39 no.9
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    • pp.18-19
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    • 2015
  • 학업 스트레스와 불규칙한 식습관으로 인해 10대 위염환자가 늘고 있다. 이는 국민건강보험공단의 '건강보험 진료비 지급' (2008~2012) 자료를 통해서도 드러나고 있는데, 그 결과를 보면 10대 위염환자 증가율이 전체 평균 3%의 두 배가 넘는 7.3%에 이르고 있다. 위염을 방치할 경우 위궤양 등 더 큰 병으로 발전할 수 있기 때문에 다음의 내용을 참고하여 위염으로부터 건강을 지킬 수 있도록 하자.

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A Convergent Study on the Necessity of Standardized Dental Health Insurance Education (표준화된 치과건강보험교육의 필요성에 관한 융합적 연구)

  • Yoo, Eun-Mi;Oh, Bo-Kyung;Kim, Min-Young;Choi, Hye-Sook
    • Journal of the Korea Convergence Society
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    • v.13 no.5
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    • pp.77-84
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    • 2022
  • The purpose of this study is to provide basic data necessary for preparing a sustainable health insurance system in the future by analyzing the difference in the results of claims according to the claims status of health insurance of dental medical institutions and the level of health insurance knowledge. In this study, a self-written online questionnaire was conducted for dental medical institutions 209 workers from March to May 2019. As a result of the study, The demand for professional manpower according to claim satisfaction was statistically significant in the qualification requirements (p<.05). Therefore, the necessity of professional workers for dental health insurance claims was confirmed and policies for this should be prepared.