• Title/Summary/Keyword: 보험수가

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A Study of the Effects of Air Pollution on Health -Emphasizing on the Aspects of Respiratory Diseases in Medical Insurance Recipients- (대기오염이 건강에 미치는 영향에 관한 조사연구 -의료보험환자에서의 호흡기질환 발생양상 분석을 중심으로-)

  • 차철환;고응린;송동빈
    • Journal of Korean Society for Atmospheric Environment
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    • v.4 no.1
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    • pp.58-70
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    • 1988
  • 대기오염이 건강에 미치는 영향의 유무를 알아보고 그 영향의 정도를 반영해 줄 수 있는 지표의 개발을 목적으로 우리나라 전역을 서울, 대도시, 중소도시, 농어촌 등 4개 지역으로 구분하고 의료보험대상자 3,922,027명에 대한 호흡기질환 외래수진률을 지역별로 비교해 보았다. 조사대상 질환군으로서는 다음 7가지의 호흡기질환을 채택하기로 하였다. 1) 결핵성 질환 2) 호흡기 및 흉곽내장기의 악성신생물 3) 급성호흡기 감염 4) 폐염 및 인플루엔자 5) 만성폐색성 폐질환 및 유사증 6) 진폐증 및 외인성의 기타 폐질환 7) 상기도의 기타질환 상기 질환으로 인한 외래수진에 관한 정보는 1983년 1월 1일 부터 12월 31일 사이에 제출된 보험의료비 청구서에 나타난 자료를 이용하여 수집하였으며, 그 분석을 통해 다음과 같은 결론을 얻었다. 1) 지역별 연간종합외래수진률을 비교해 본 결과 농촌지역에서 가장 낮은 수준을 나타내고 있는 질환은 조사대상 7개 호흡기질환군중 다음 4개 질환군이 해당되고 있다. (1) 결핵질환 (2) 호흡기 및 흉곽내장기의 악성 신생물 (3) 상기도의 기타질환 (4) 진폐증 및 외인성의 기타 폐질환 한편 이 종합외래수진률이 가장 높은 지역은 대도시 지역으로서 5가지 호흡기질환군의 수진률이 다른 지역에 비해 훨씬 높게 나타나 있다. 이와같은 결과는 의료보험환자들의 "외래수진률"을 이용하여 대기오염과 건강과의 관련도를 측정할 수 있는 "대기오염 - 건강" 지표의 개발이 가능할 것임을 뒷받침해 주고 있다. 그러나 가장 오염도가 높다고 예상되는 서울지역에서의 외래수진율이 대도시 지역보다 높지 않다는 것은 오염도와 외래수진률과의 관계에서 일관성있는 결과를 보여주지 못하고 있음을 뜻하는데 과거의 자료로서는 외래수진률만 가지고 대기오염과 건강과의 관계를 표시해주는 지표로 삼기에는 미흡함을 알 수 있다. 2) 월별 외래수진률의 경향을 보면 거의 모든 호흡기질환군에서 계절적인 특이성을 나타내지 못하고 있다. 단 이 경우도 농촌지역이 연중 계속 최하위를 유지하고 있는 질환군이 7개 대상질환군 중에 4개군에 달하고 있다. 3) 보험환자들의 "외래수진률"은 아직은 미흡한 점이 있으나 앞으로 "대기오염 - 건강" 지표로서 개발 활용할 가치는 있다고 볼 수 있으며 서울, 대도시, 중소도시, 농어촌 등 4개 지역에 대한 월별 외래 수진률을 다음 4가지 질환군에 대하여 계속 관측하여 그 경향을 분석할 것을 권장한다. (1) 호흡기 및 흉곽내장기의 악성 신생물 (ICD. 160-165) (2) 급성호흡기 감영 (ICD. 460-466) (3) 폐염 및 인플루엔자 (ICD. 480-487) (4) 만성폐색성 폐질환 및 유사증 (ICD. 490-496) 4) 외래수진률은 진료방식 즉, 투약기간의 장단등으로 인한 통원 (通院) 빈도 차이의 영향을 받게 되므로 지역별 병 $\cdot$ 의원의 보험환자 진료방식에 대한 비교검토가 요구된다.

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A Study on Damage Assessment for Fuel Cell Facilities in Gas Stations (주유소 내 연료전지설비에 대한 사고피해예측 연구)

  • Sung Yoon Lim;Jang Choon Lee;Jae Hoon Lee;Seung Ho Choi
    • Journal of Korean Society of Disaster and Security
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    • v.16 no.1
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    • pp.71-80
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    • 2023
  • Fuel cells are low-carbon power sources that can expand distributed energy system and electric vehicle charging infrastructure when installing fuel cells in gas stations. In order to ensure safety for fuel cells in gas stations, quantitative risk assessments were conducted after deriving accident scenarios based on accident data of domestic and foreign gas stations and fuel cells. It calculates the expected extent of damage from fire and explosion that can occur in reality, not the worst accident scenario, and analyzes the damage impact. The separation distance of more than 9.0 m from a dispenser, 15.5 m from a car under refueling, 4.1 m from the ventilation pipe, 1.1 m from the gas adjustment device prevent the severe damage caused by the expected accident. This study result can be used to deploy fuel cells in gas stations and establish safety measures.

The Effects of M-CRM Characteristics, Market Orientation on Customer Loyalty and the Moderating Role of Relationship Length in Insurance Companies (보험기업의 M-CRM 특성과 시장지향성이 고객충성도에 미치는 영향: 관계기간의 조절효과)

  • Jung, Chul-Ho;Jung, Duk-Hwa
    • The Journal of the Korea Contents Association
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    • v.16 no.6
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    • pp.726-738
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    • 2016
  • This paper aims to examine structural relationship between the influence factors of customer loyalty, hypothesizing that m-CRM characteristics, market orientations, relationship quality and relationship length plays a crucial role in achieving customer loyalty in insurance companies. Total of 255 valid sample data were used to test study hypotheses. By using Structure Equation Modeling(SEM) method, the results show that m-CRM characteristics and customer orientation significantly influence to relationship quality except competitor orientation and all relationship quality are very significantly influence to customer loyalty being consisted of customer retention and word of mouth effect. In addition, the modulation effect of relationship length is confirmed about relationship between relationship quality and customer loyalty. A real situation we conducted our research may enable academics and practitioners to understand the antecedents and outcomes of m-CRM implementation in terms of market orientation.

A Study on the Implementation of Due Diligence and Its Effect - Focussing on the Marine Hull Insurance - (상당주의의무의 이행과 그 효과에 관한 연구 - 선박보험을 중심으로 -)

  • Lee, Sang-Wook;Nam, Young-Eun;Park, Sang-Gap
    • Journal of Navigation and Port Research
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    • v.26 no.4
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    • pp.399-406
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    • 2002
  • There may be some cases in which underwriters refuse to pay claims to the assured in case of his want of due diligence and actually, a lot of cases which an assured could not have been covered, existed through the history of marine hull insurance claims. Statistically, looking back the past marine accident cases in korea, the most parts of the accident are man-made disasters caused by want of due diligence. So, this study will focuss on this kind of marine losses and insurance clauses and other relevant rules containing due diligence such as due diligence of the assured in inchmaree clause, ITC-Hulls(1983), and due diligence of carrier in Hague-Visby Rule and so on. This study also shows what the disadvantages to marine enterprisers are, caused by want of due diligence and the advantages of doing due diligence are. In conclusion, this study contends that marine enterprisers should perform due diligence in dong their business for both financial stability and good management of their companies.

Unit Costs of Care Services in Long-Term Care Insurance in Korea - Its Characteristics and Evaluation - (노인장기요양보험 수가 개발의 특성과 평가)

  • Seok, Jae-eun
    • Korean Journal of Social Welfare Studies
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    • no.39
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    • pp.253-286
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    • 2008
  • The care market has a unique characteristic that cannot be understood only by pure consumerism. It is not simply constituted by the relationship between consumers and providers at a uni-dimensional level of consumerism logic; rather, it operates in the tripartite-dimensional relationship between the state, consumers and providers through the design and regulation of policies by the state(Evers 1994). The unit costs of long-term care insurance has a meaning as the signal of state for policy direction. This paper consists three contents. The first, it provides to examine the developing process and method of the unit costs of long-term care and to define the characteristics of the developing method of unit costs of the Korean Long term care Insurance. The second, it tried to evaluate the adequacy, validity, and equity of unit costs of care. The third, it proposed the policy direction and measures focused on state's role as price determinator and regulator of care market in that unit costs of care is very important factors for formation and operating of care market.

Coverage Method in German Workers' Compensation Insurance and Policy Implications: Focusing on Volunteers and Persons in Special Types of Employment (독일 산재보험제도의 적용방식과 시사점: 자원봉사자와 특수형태근로종사자 중심으로)

  • Kim, Sang Ho
    • 한국사회정책
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    • v.20 no.3
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    • pp.171-195
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    • 2013
  • One of the current issues in Workers' Compensation Insurance is about the coverage range. Korea uses the definition of worker under the Labor Standards Act in Workers' Compensation Act and solved the problems associated with the coverage range of insurance group by the exceptional clause only for the groups which was raised about the need for the social protection. The purpose of this paper is to draw implications for solving problems which are associated with the coverage range of insurance group by reviewing the German literature. We focus on volunteers and persons in special types of employment. German government supports the activity of volunteers by providing with the protection service against the accidents. This paper shows how the coverage range is extended from the dependent employees in the introduction of the Workers' Compensation Insurance to the people who need social protection focusing on the volunteers. The implications of this research are following. First, German system shows that Workers' Compensation Insurance can be extended to the groups which do not belong to the dependent employee but are worthy of protection. Second, it is necessary to provide volunteers in the social welfare system with the protection service against the accidents and the statutory accident scheme is recommendable to use. Third, volunteers in the social welfare system need to be compulsory insured. Fourth, Korea should find their own way in solving problems associated with persons in special types of employment.

The Difference-in-Difference Model Analysis about the Effects of Long-Term Care Insurance on Family Relationships' Change (노인장기요양보험제도가 가족관계의 변화에 미치는 영향에 대한 이중차이모델 분석)

  • Min, Kichae
    • 한국노년학
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    • v.31 no.4
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    • pp.999-1014
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    • 2011
  • The purpose of this study is to examine the effects of long-term care insurance(macro-system) on family relationship(micro-system)s' change based on ecosystems theory. Data come from the second(2007) and the fourth(2009) Korean Welfare Panel Study(KWPS). Experimental group is the beneficiary using long-term care insurance and the member of household in their households, and control group is the non-beneficiary not using long-term care insurance and the member of household in their households. The main findings of difference-in-difference model analysis are as follows. First, the ecosystems theory is a theory examining the correlation between long-term care insurance and family relationship. Second, the effects of long-term care insurance is not income effect but independent effect. This result shows that the meaning of family has faded away and family relationship has been weaken and that long-term care insurance has not complete characteristics as a social insurance. Thus, system reforms of long-term care insurance is highly needed for system comprehensiveness, coverage, adequacy, and service accessibility and is changed into family-friendly social policy.

An analysis of Korea-China FTA Service Chapters and Implications for Further Negotiations Strategy -With special focus on the Insurance Market- (한-중 FTA 서비스 분야의 분석에 따른 향후 추가협상에 대한 시사점 : 보험시장을 중심으로)

  • Hwang, Ki-sik;Choi, Shin-young;Kim, Se-jin
    • Journal of International Area Studies (JIAS)
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    • v.22 no.2
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    • pp.217-244
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    • 2018
  • As Chinese insurance market grows rapidly due to market reforms, China got recognition as second-largest insurance market in the world in 2016. However Korean insurance companies have had difficulties to grow in Chinese insurance market despite Chinese participation in the World Trade Organization (WTO) and the growth of chinese insurance market. The reason for the decline in Korean insurance companies is economic retaliation due to the deployment of THAAD in Korea. However, this is not a fundamental reason. The underlying cause of the effects of economic retaliation is the result of insufficient negotiations in Korea-China FTA services sector. In Service sector of Korea-China FTA, the level of concession between Korea and China differs greatly, when comparing China and South Korea's FTA. In addition, it has only been a few years since China collected the position of the WTO Doha Agenda, which currently deals with concessions on intellectual property rights and services. More important is that the Korea-China FTA service sector, as it stopped short of being protected by the most-favored-nation state treatment level when Korean insurance companies entered China. Further negotiations to supplement the weak points in the Korea-China FTA service sector were promised in December 2017, but international tensions over THAAD deployment made it impossible to hold such negotiations. However, due to changes in international affairs in 2018, the first additional negotiation was decided and held. This paper implicates strategies of further negotiation between Korea and China for service and investment chapter. Consequently, the aim of this paper suggests directions how to re-enter Chinese insurance market to Korean insurance companies.

Determinants of Purchasing Indemnity Private Health Insurance among Adolescents and Children (소아 및 청소년의 실손형 민간의료보험 가입 결정요인)

  • You, Chang Hoon;Kang, Sungwook;Choi, Ji Heon;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.99-110
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    • 2018
  • As interest in adolescent and children's health risks increases, there is an increase in subscriptions to indemnity private health insurance. The purpose of this study was to investigate determinants of purchasing indemnity private health insurance. We conducted panel logit regression analysis on the sample of 4,567 adolescent and children using Korean Health Panel data from 2009 to 2015. As a result, it was analyzed that the participation of private health insurance for children and adolescents was affected not only by the characteristics of children and adolescents (age, birth order, residence, disability) but also by the characteristics of father (indemnity, disability, chronic disease) and mother (age difference between her and her children, indemnity, unmet needs) and the economic level of households (income). In views of this study, it is necessary to continuously implement policies to strengthen the healthcare of children and adolescents in order to alleviate the anxiety about the health risks of children and the burden of medical expenses caused by late marriages and maternal births. In particular, it is necessary to consider policies for multi-child families and vulnerable classes.

The Strategies for Strengthening the Competitiveness of Life Insurance Companies (생명보험회사의 경쟁력 강화 방안에 관한 연구)

  • Jung, Se-Chang
    • The Korean Journal of Applied Statistics
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    • v.21 no.5
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    • pp.775-781
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    • 2008
  • The purpose of this paper is to analyse the key factors influencing the life insurance companies's competitiveness. Various performance variables differentiate this paper other existing studies employing a single performance variable. The business activity is divided into two categories, the underwriting activity and the investment activity. Each activity produces two performance, cost and profit performance. This study analyses the factors influencing four performance variables and suggests implications enforcing the life insurance companies' competitiveness based on the analysis. The results of this study are summarized as follows. Firstly, we find a statistically significant correlation between the cost performance in the under-writing activity and other performance variables. However, there in not a statistically significant correlation between the other three performance variables, the cost performance in the investment activity, the profit performance in the under-writing activity. Secondly, it is desirable to increase the selling of protection products for enforcing the competitiveness in respect of the cost performance. Finally, it is needed to increase the ratio of loans for enforcing the competitiveness in the area of the investment activity.