• Title/Summary/Keyword: 보험수가

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A Study on the Judgement Rating for Level of Need for Long-term Care Insurance Using a Decision Tree (노인 장기요양보험의 등급판정을 위한 의사결정나무 연구)

  • Han, Sang-Tae;Kang, Hyun-Cheol;Choi, Bo-Seung;Lee, Seong-Keon
    • Communications for Statistical Applications and Methods
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    • v.18 no.1
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    • pp.137-146
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    • 2011
  • Long-term care insurance is a social insurance system that provides benefits to the elderly who have difficulty taking care of themselves for a period of at least 6 months. This system was started in July, 2008 and it is very important to set proper judgement ratings for the approval process. We try to develop and improve the judgement rating system using decision tree models. Our tree model is found to be more stable and efficient than the previous one.

Study on Assumptions for Fractional Ages in Life Insurance (생명보험에서 수명분포 단수부분에 대한 가정에 관한 연구)

  • Lee, Soo-Bin;Cha, Ji-Hwan
    • The Korean Journal of Applied Statistics
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    • v.25 no.1
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    • pp.1-13
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    • 2012
  • An assumption for fractional ages should be made to obtain the net premium of the whole life insurance payable at the moment of death based on the life table. Most existing studies adopt the assumption of the uniform distribution(UDD) for the fractional ages. However, as seasonal changes may frequently lead to the deaths of elderly people, it is questionable whether the assumption of the uniform distribution is the most appropriate one for the entire age intervals. In this article, based on a real mortality data set, the appropriateness of UDD assumption for the entire age intervals is examined. And then we propose a more suitable model for fractional ages. We analyze the effect of UDD assumption through the net premium and the corresponding risk when the true distribution for the fractional ages is not uniform.

Demand Prospect of Professional Workers in Execution of the Elderly's Long-Term Care Insurance -Nurse, Social Welfare, Care Probation Professional workers- (노인 장기요양 보험제도 실시에 따른 전문직종사자의 수요 예측 -간호사, 사회복지사, 요양보호사를 중심으로-)

  • Park, Myung-Sun;Kang, Sang-Mok
    • Communications for Statistical Applications and Methods
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    • v.17 no.3
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    • pp.423-440
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    • 2010
  • The purpose of this paper is to prepare the department creation and the staff increase of education institution by forecasting the demand of health and welfare workers according to execution of the elderly's long-terms treatment insurance system in July, 2008. We estimated confirmors of the elderly's long-terms treatment and the demand of professional workers of health and welfare field due to the increase of care insurance users in facilities treatment organization, care at home service facilities, and family allowance facilities for 2010-2030. The numbers of social welfare professional worker are estimated as 16,624 workers in 2020 and 24,688 workers in 2030. The numbers of nurses are forecasted as 11.287 in 2020 and 16,624 in 2030, we expect that the increase of the demand be accelerated. The demand of necessary care probation worker is 44,824 in 2009, but we already trained over around 500,000 workers in 1,078 education institutions through one year in Aug. 31, 2009, which excesses over the numbers of workers demanded as much as 10 times.

Korean Long-Term Care Insurance System and Caring Justice (노인장기요양보험제도와 돌봄 정의)

  • Choi, Hee Kyung
    • 한국사회정책
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    • v.25 no.3
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    • pp.103-130
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    • 2018
  • The study aims to analyse Korean Long-Term Care Insurance system in terms of caring justice on the premise that elder care should be included in discussions and policies of care. Caring justice means an ideal of equal sharing duties and rights of care by all citizens. Four dimensions of caring justice(decommodification, defamilialization, degenderization and elderly participation and power) were established for the analysis. The results of the analysis were presented that Korean Long-Term Care Insurance system was maintained by commodificated and gendered care services attempting defamilialization with the exclusion of elderly beneficiaries, which represented typical caring injustice. Policy suggestions were made to realize caring justice: improving the status of caring labour by achieving proper service price and public employment, reorganization of life cycle based caring system integrating children, disabled adults and elders, and developing user-centered long-term care system to guarantee participation and choice of people in caring relationships.

A study on the characteristics of severe trauma patients by health insurance system (건강보험제도에 따른 중증외상 환자 특성 비교 연구)

  • Choi, Mi-Young;Lee, Hyo-Ju;Yun, Seong-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.309-313
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    • 2022
  • This study was attempted to analyze the status of emergency room use of severe trauma patients using the health insurance system and to understand their characteristics. This study used data from the 'Community-based Severe Trauma Surveillance' investigated from January 1, 2018 to December 31, 2019. As a result, there were differences in the degree of disability after injury and whether treatment(surgery, trauma embolism, transfusion) was performed according to the type of medical insurance (p< .001), it was found that there was a statistically significant difference between the degree of disability before and after damage depending on the type of medical insurance (p< .001). Reviews of the health insurance system located for the well-being of the people should be continued from various angles, and specific improvement plans should be proposed.

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The Limitation of the Military Aviation Manufacturer's Liability (우리나라 군용항공기 제작사의 책임제한 해결방안에 관한 고찰)

  • Shin, Sung-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.1
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    • pp.139-175
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    • 2017
  • The Assembly plenary session on December 3, 2017 passed a Product Liability Amendment bill that introduced clauses concerning consumer burden of proof and punitive damage reimbursement. More specifically, these newly approved provisions will reduce the burden of proof placed on consumers and levy triple punitive damage on suppliers. Significant increases in the number of product-liability lawsuit and the number of related insurance contracts are expected. Since military aircraft are designed for operational purpose(seeking greater combat effectiveness over greater safety) and used in high-risk environment, it is practically impossible to obtain an affordable product-liability insurance, Without having any backup plan, military aircraft manufacturers directly face all sort of liability risks under Product Liability Act, Warrant Liability Act and Non-Performance of Contract Act. The U.S. experienced similar problems when they first implemented their product-liability law in 1970s. There had been a big dispute among legal practitioner, insurance professionals and scholars concerning military aircraft manufacturer's liability. In order to settle the issue, the U.S. Supreme Court has established a new precedent of Government Contractor Defense(GCD). The U.S. government also included an indemnity clause for military aircraft manufacturers in their FMS Contract with the Korean government. Likewise, Korean military aircraft manufacturers should 1) clearly understand their current position that they cannot afford expensive product-liability insurance and the cost is not accounted in the military procurement calculation, 2) estimate potential liability risks with the ongoing overseas export expansion in mind, 3) set up appropriate risk management measures through regulatory reform and policy development.

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A Study on Factors Affecting Reemployment of the Disabled Workers owing to Industrial Injury in Korea (산재장애인의 재취업실태와 영향요인 분석)

  • Park, Soo-Kyeong
    • Korean Journal of Social Welfare
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    • v.37
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    • pp.171-193
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    • 1999
  • The ultimate goal of rehabilitation is social integration. Reemployment is, for the disabled workers, the primary source of not only income, but also identity and interaction. Unfortunately, for most disabled workers employment represents only a yet-to-be-fulfilled hope, a close but inaccessible goal, a daily reminder that they are not among the majority. The purpose of this study is to estimate reemployment rate in the industrial injured and to find factors affecting reemployment of disabled workers owing to industrial injury, and to make policy implication for the better industrial injury compensation rehabilitation system. The data were obtained through telephone interview with disabled worker who completed work injury compensation process in 1996-1997. The final sample was consisted of 1,060 respondents. The major findings were that almost lout of 3 disabled worker returned to work, and that the factor affecting reemployment of the disabled workers were severity injury, ADL(activity of Daily Living), the perception of disability severity, controlling for the demographic factors such as sex, age, education, marital status. The results indicated that psychosocial factors as well as physical function had influces on returning to work. The current findings suggests that rehabilitation services and policy aimed at enhancing vocational rehabilitation program and rehabilitation engineering services, and improving psychosocial resources should be considered by rehabilitation professionals and policy makers.

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Analysis of current nursing homes in Korea and to assess the role and prospect of dentists in comparison to Japanese long term care insurance system (한국노인요양시설 구강 위생 현황과 일본 노인요양보험법 비교를 통한 치과의사의 역할과 전망)

  • Shin, Ri-Hye;Bae, Hanna Eun-Kyong;Choi, Sung-Ho;Park, In-Im; Ohyama, Takashi;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.83-91
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    • 2008
  • Statement of problem: The introduction of "The Long-term Care Insurance System" (a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. Purpose: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. Material and methods: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. Results: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.

A Comparative Study on Seafarers' Industrial Accident Compensation System - Focusing on the German Legislation - (선원재해보상에 관한 비교법적 연구 - 독일의 법제를 중심으로 -)

  • Park, Jun-Mo;Park, Sung-Ho
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.4
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    • pp.567-576
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    • 2022
  • Seafarers are exposed to various unpredictable maritime risks due to the spatial specificity of the working environment of the sea; thus, sufficient compensation for injured crewmembers is needed. However, Korea does not provide such compensation. Therefore, this study attempted to examine the Maritime Labor Act and the Industrial Accident Insurance Act of Germany, an advanced European social insurance country, and derive implications compared to Korea. First, we investigated how compensations are managed by a public institution in Germany and by shipowners in Korea. Second, regarding the contents of accident compensation, Germany does not only provide continuous treatment and care through various support systems, but also operates various programs to enable a return to ship work. In contrast, Korea has a temporary compensation system that allows shipowners to avoid liability for accident compensation, which is disadvantageous to shipwrecked seafarers. Finally, in Germany, workers' compensation insurance is public, judged considering the origin of work, whereas in Korea, it is determined by shipowners or insurance companies. Therefore, it is necessary to establish a public institution in charge of crew accident compensation to ensure proper compensation for crewmembers in Korea and to improve the Seafarers Act or system to provide compensation for additional medical care, disability pension, and rehabilitation benefits.

Analysis of Barriers and Activating Factors of Visiting Nursing in Long-term Care Insurance (노인장기요양보험 방문간호의 장애요인 및 활성화 방안)

  • Lim, Ji-Young;Kim, Eun-Joo;Choi, Kyung-Won;Lee, Jung-Suk;Noh, Won-Jung
    • The Journal of the Korea Contents Association
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    • v.12 no.8
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    • pp.283-299
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    • 2012
  • The aim of this study is to develop strategies activating long-term care visiting nursing. The research design was a descriptive survey study, and the data were collected from the visiting nursing center managers, customers, and long-term care insurance staffs. The major results were as follows. To activate the long-term care visiting nursing, first, the basic nursing care for ensuring sustainable health management has to be included. Second, the visiting nursing must be designated as mandatory use in standard guideline for using long-term care services. Third, the insurance pricing of visiting nursing must be based on the cost of visiting nursing. And, last, using a visiting nursing must be possible without a doctor's order sheet, when it is required for the assessment of patient's health status.