• 월간 기계설비
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• s.270
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• pp.59-63
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• 2013

조달청이 지난해 12월 27일 국민건강보험공단본부 신사옥 건축공사(설계금액 1,496억원)와 진접-내촌 도로건설공사(설계금액 1,396억원)를 주계약자 공동도급으로 발주한다고 밝혔다. 국민건강보험공단 본부 신사옥 건립공사는 조달청이 맞춤형 서비스로 집행하는 사업으로 부계약자인 전문건설업체는 기계설비공사업체(덕트설비공사 약 57억원)를 적용하기로 했다. 이는 정부 발주공사에서 주계약자 공동도급에 의해 처음 발주된 것으로 앞으로 모든 공공공사에 주계약자 공동도급이 확대될 전망이다. 조달청의 이번 주계약자 공동도급 발주는 대한설비건설협회가 그동안 국민건강보험공단과 조달청에 기계설비공사를 주계약자 공동도급으로 발주해 줄 것을 건의한 결과이다.

• Proceedings of the Korea Information Processing Society Conference
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• 2012.11a
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• pp.472-473
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• 2012

수준 높은 공공서비스를 제공받고자 하는 국민의 권리의식이 향상되고 정보기술의 급속한 발전에 따라 고객의 요구사항이 다양하다. 신속하고 정확한 상담의 서비스를 제공하기 위한 수단으로서 콜센터에 대한 필요성이 높아지고 있다. 공공기관의 고객접점인 콜센터에서 근무하는 상담원들의 직무특성과 직무태도를 통하여 직무만족과 이직의도에 대한 상관관계를 분석하고자 한다. 이직의도를 낮추기 위해서는 상사의 관심과 지원이 중요한 요소로 나타났다. 본 연구의 의의는 고객접점을 운영함에 있어서 직무상 발생하는 스트레스를 효율적으로 관리하여 상담원의 직무만족을 증대시켜 이직의도를 낮추는데 기여하고자 한다.

• Health Policy and Management
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• v.33 no.2
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• pp.166-172
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• 2023

Background: To improve the support low-income individuals' medical expenses, it is necessary to think about ways to enhance the Catastrophic Health Expenditure Support Program. This study proposes expanding support criteria and changing the income standard. Methods: This study conducted simulations using national data from the National Health Insurance Service. Simulations performed for people who have used health services (n=172,764) in 2022 to confirm the Catastrophic Health Expenditure Support Program's size based on changes to the subject selection criteria. Results: As a result of the simulation with expanded criteria, the expected budget was estimated to increase between Korean won (KRW) 13.2 (11.5%) and 138.6 billion (37.4%), and the number of recipients increased between 41,979 (48.9%) and 150,317 (76.1%). The results of the simulation for the change in income criteria (applied to health insurance levels below the 50th percentile) estimated the expected budget to increase between KRW -8.9 (-7.8%) and 55.6 billion (15.0%) and the number of recipients to increase between -8,704 (-10.1%) and 41,693 (21.1%) compared to the current standard. Conclusion: The 2023 Catastrophic Health Expenditure Support Program's criteria were expanded as per the 20th Presidential Office's national agenda to alleviate the burden of medical expenses on the low-income class. In addition, The Catastrophic Health Expenditure Support Program needs to be integrated with other medical expense support policies in the mid- to long-term, and a foundation must be prepared to ensure the consistency of each system.

• Health Policy and Management
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• v.33 no.4
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• pp.400-410
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• 2023

Background: As the government has recently been discussing the expansion of the disaster health expenses support project, we would like to confirm the characteristics of beneficiaries of the support project, particularly those of high-cost beneficiaries. Methods: Using the database of catastrophic health expenditure support project from 2019-2020, this study aims to confirm the characteristics of high-cost beneficiaries focusing on the overlap of the relieved out-of-pocket systems, known as the out-of-pocket ceiling system and the system for rare incurable diseases. Logistic regression analysis is used to examine this issue. Results: In order to analyze the factors influencing high-cost beneficiaries, five models were created and analyzed, including the status of duplicated beneficiaries for relieved out-of-pocket systems, sociodemographic and economic factors, and individual health status as sequential independent variables. All five models were statistically significant, of which economic factors had the greatest impact on the model's predictions. The main results indicated that those who benefited from multiple systems in duplicate were more likely to be high-cost beneficiaries, and there is a higher probability of incurring high health expenses among the underage. In addition, within the beneficiaries of catastrophic health expenditure support project, it was observed that higher health insurance premium percentiles are associated with a higher proportion of high-cost beneficiaries. Conclusion: This study examined the characteristics of high-cost beneficiaries by encompassing reimbursement and non-reimbursement. According to this study, it is expected to be used as basic data for setting priorities and improving the current criteria of catastrophic health expenditure support project, aiming to sequentially expand the program.

• Korean Journal of Health Education and Promotion
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• v.3 no.1
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• pp.21-28
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• 1985

우리 정부가 복지사회 구현의 일환으로서 관심을 가지고 국민의 건강을 위하여 오늘날과 같이 많은 노력을 기울이고 있은 적은 일찍이 없었으며 제오차 경제사회개발계획에서도 일차보건의료와 의료보험의 조기정착 그리고 인구대책에 대한 정부의 강한 의지를 표명하고 있어 국민건강증진과 사회발전을 위하여 국가보건정책을 크게 향상시키려는 노력을 계속 모색하고 있음을 알 수 있다.

• 건강소식
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• v.32 no.3 s.352
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• pp.14-15
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• 2008

치질은 전형적인 한국인의 질병이다. 국민건강보험공단과 건강보험심사평가원 등 정부기관이 집계한 자료에 따르면 입원환자수가 가장 많은 질병이 다름 아닌 치질인 것으로 나타났다. 이를 증명하듯 건강보험 통계연보를 살펴보면 최근 6년 사이 치질 입원 환자 수는 12만 명에서 22만 명으로 2배 정도 급증했다. 그만큼 치질은 우리 주변에서 흔히 볼 수 있는 대표적 질환인데 가끔씩 배변 후 명미한 출혈까지 포함한다면 거의 대부분의 사람들이 치질 증상을 경험해 봤다고 하겠다.

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.663-683
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• 2015

The change of the population pyramid due to low fertility and rapid aging threatens the financial sustainability of National Health Insurance. We construct statistical models for prevalence rates and medical expenses using National Health Insurance Service (NHIS) sample cohort data from 2002-2013. We then project yearly expenditures and income of national health insurance until 2060 that considers various assumptions in regards to future population structure and economic conditions. We adopt a VECM-LC model for prevalence rates and the double exponentially smoothing method for the per capita co-payment of healthcare expense (in which the two models are institution-disease-sex-age specific) to project of national health insurance expenditures. We accommodate various assumptions of economic situations provided by the national assembly and government to produce a financial projection for national health insurance. Two assumptions of dependents ratios are used for the projection of national health insurance income to conduct two future population structures by the two assumptions of aging progresses and various assumptions on economic circumstances as in the expenditure projection. The health care deficit is projected to be 20-30 trillion won by 2030 and 40-70 trillion won by 2060 in 2015 constant price.

• Health Policy and Management
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• v.29 no.2
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• pp.195-205
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• 2019

Background: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. Methods: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. Results: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). Conclusion: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.

• Health Policy and Management
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• v.33 no.3
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• pp.355-362
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• 2023

Background: Financial efficiency in monetary units and operational efficiency in non-monetary units are separately classified and evaluated. This is done to prevent the duplication of monetary units and non-monetary units in inputs and outputs. In addition, analyses are conducted to determine the factors that affect each aspect of efficiency. To prevent duplication of monetary and non-monetary units in inputs and outputs, financial efficiency, consisting of monetary units, and operational efficiency, comprising non-monetary units, are separately classified and evaluated. Furthermore, an analysis is conducted to identify the factors that affect each aspect of efficiency. Methods: This study conducted a panel analysis of 34 regional public hospitals and influencing factors on efficiency for 5 years from 2015 to 2019. Financial efficiency and operational efficiency were calculated through data envelopment analysis. Moreover, multiple regression analysis was conducted to identify the factors that influence both financial efficiency and operational efficiency. Results: The factors that affect financial efficiency include the number of medical institutions within the treatment area and the ratio of patients receiving medical care. Additionally, operational efficiency is influenced by the type of medical institution, the number of medical institutions within the treatment area, and the number of nursing positions per 100 beds. Conclusion: In order for regional public hospitals to faithfully fulfill their functions and roles as regional base public hospitals, several measures are necessary. Firstly, continuous monitoring and reasonable support are required to ensure efficient operation and performance. Secondly, a financial support plan tailored to the characteristics of local medical centers is needed. Additionally, local medical centers should strive to enhance their own efficiency.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.169-175
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• 2021

Objectives : Delirium is a temporary brain dysfunction and systemic inflammation is important factor in its pathophysiology. Whether the neutrophil-lymphocyte ratio (NLR), one of the inflammatory markers, can be used as an inflammatory marker in delirium patients was investigated in comparison with C-reactive protein (CRP). Methods : We retrospectively reviewed the medical records of patients who were referred for consultation for delirium at hospital for one year. The NLR and CRP values at admission and delirium status were divided into the medical and the surgical treatment group, and the interaction between them was analyzed through repeated measures ANOVA. Results : NLR was maintained without significant difference before and after delirium in the medical treatment group and the surgical treatment group, but CRP decreased in the medical treatment group and increased in the surgical treatment group during delirium, showing a significant interaction. Conclusions : In delirium patients, the NLR remained constant, but the CRP differed according to the treatment group and the delirium state. This suggests the possibility that NLR could be used complementary to CRP as an inflammatory marker in delirium patients.