• Health Policy and Management
• /
• v.31 no.3
• /
• pp.261-271
• /
• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• Journal of Digital Convergence
• /
• v.17 no.11
• /
• pp.201-206
• /
• 2019

While many users searched for insurance information online, there were not many cases of contents recommendation researches on insurance companies' websites. Therefore, this study proposed a page recommendation system with high possibility of preference to users by utilizing page visit history of insurance companies' websites. Data was collected by using client-side storage that occurs when using a web browser. Collaborative filtering was applied to research as a recommendation technique. As a result of experiment, we showed good performance in item-based collaborative (IBCF) based on Jaccard index using binary data which means visit or not. In the future, it will be possible to implement a content recommendation system that matches the marketing strategy when used in a company by studying recommendation technology that weights items.

• Health Policy and Management
• /
• v.31 no.2
• /
• pp.173-179
• /
• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• Journal of the Korean Society of Radiology
• /
• v.81 no.5
• /
• pp.1053-1068
• /
• 2020

In accordance with the new healthcare policy of government (Moon Jae-In Care) to strengthen health insurance coverage, the National Health Insurance (NHI) coverage of brain magnetic resonance imaging (MRI), brain/neck MR angiography (MRA), and head and neck MRI have been expanded since 2018 in Korea. This article has been reviewed focusing on the "Detailed matter concerning criteria and method for providing reimbursed services in the NHI. Some revisions" regarding reimbursement for MRI, which was revised from October 2018 to April 2020 and is currently in effect. It included the MRI reimbursement system in Korea, recent adjustment of the reimbursement coverage for patients with headache or dizziness, and reimbursement coverage, standard imaging, and radiologic report of brain MRI, brain/neck MRA and head and neck MRI. This article could help radiologists gain knowledge on health insurance to protect the expertise of the radiologist and to play a leading role in the hospital. As the policy changes, detailed matter concerning criteria and method for providing reimbursed services in the NHI may be revised. Therefore, radiologists should update issues related to insurance reimbursement for MRI continuously.

• The Korean Society of Law and Medicine
• /
• v.18 no.1
• /
• pp.237-264
• /
• 2017

With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.12 no.2
• /
• pp.401-410
• /
• 2017

This study aimed to identify appropriateness and efficiency in the DRG payment system by analysing the hospital length of stay and changes in fees before and after the application of DRG payment system. The subjects of the study were a total of 398 patients consisting of 204 for the fee for service system and 194 for the DRG payment system. They received surgery in the Obstetrics and Gynecology (OBGY) department of a general hospital in G metropolitan city between January and December 2013. The mean hospital length of stay was significantly decreased after application of the DRG payment system(p=0.013). Total fees, insurance charges, and deductions increased significantly(p<0.001), and non-payment charges and total deductions decreased significantly(p<0.001). Application of the DRG payment system reduced length of stay, non-payment charges and total patient's cost sharing and increased out-of-pocket, insurance charges, and total fees.

• Journal of dental hygiene science
• /
• v.11 no.1
• /
• pp.31-35
• /
• 2011

The purpose of this study was to examine the state of the claim of dental clinics for payment from the national health insurance corporation in a bid to provide some information on the efficient management of payment claim by dental institutions. The findings of the study were as follows: As for the form of payment claim, 45.4 percent claimed payment by themselves, and 54.6 percent asked an agent to do that on behalf of them. Concerning the type of occupation of the applicants, dental hygienists demanded payment in the biggest number of the dental clinics(78.2%). The most common number of cases that the dental clinics demanded payment was between 201 and 400(40.3%). The dental clinics asked an agent to claim payment when the number of payment claim cases was smaller, and they claimed payment by themselves when the number of payment claim cases was larger. Regarding the reason why the dental institutions asked an agent for payment claim, the biggest group(28.0%) cited complicated claim procedure as the reason, and the second largest group(22.6%) answered that they weren't used to doing that. The third greatest group(20.8%) pointed out a shortage of personnels that would be responsible for that as the reason.

• Korean Journal of Agricultural and Forest Meteorology
• /
• v.25 no.3
• /
• pp.197-207
• /
• 2023

This study was conducted with the purpose of measuring the disaster damage reduction effect according to the provision of the early warning service ahead of the nationwide expansion. The damage reduction effect was measured using insurance data for 19 insured crops in areas that early warning services were provided during the period from 2017 to 2020. As a result of the measurement, it was analyzed that the early warning service had the effect of preventing or reducing disaster damage to farms. In particular, it was found that the disaster reduction effect was greater when disaster prevention facilities were equipped. The implications obtained from the results are as follows. First, by presenting subjectively experienced disaster reduction cases as numerical effects using insurance data with public confidence and objectivity, it can be used as basic data such as expansion of service area, discount of insurance premium with service adoption, and promotional materials for service subscription for early warning service. Second, in expanding and distributing early warning services, giving priority to areas or crops equipped with disaster prevention facilities can help increase the efficiency and effectiveness of the project.

• The Optical Journal
• /
• s.159
• /
• pp.17-19
• /
• 2015

스스로 주행하는 지능형 자동차가 천천히 하지만 뚜렷하게 우리에게 다가오고 있다. 실험주행 수준이지만 자동주행 자동차가 실제 도로 위를 누비고 있다. 구글, 테슬라 그리고 애플, 다른 한편에 비엠더블유, 다임러 벤츠 그리고 폭스바겐. 미국 기업과 독일 기업 사이에는 전운마저 감돌기 시작했다. 누가 미래 기술을 선도할 것일까 그리고 이를 통해 다양한 비즈니스의 폭발성을 선점할 것인가를 놓고 실리콘 벨리의 기술 기업과 유럽 대륙의 전통 자동차 기업의 한판 대결을 준비하고 있다. 자동주행 자동차는 기술의 문제로 제한되지 않는다. 자동주행 자동차는 어떻게 교통안전을 담보할 수 있을까, 자동주행 자동차는 새로운 시간과 생활의 가치를 어떻게 제공할 수 있을까, 만약 사고가 발행할 경우 그 책임소재는 어떻게 다툴 것인가, 자동차 보험은 어떻게 재편할 수 있을까 등 무수한 사회문제를 동반하고 있다.

• RED RIBBON
• /
• s.79
• /
• pp.18-19
• /
• 2008

인류의 건강을 해치고 생명을 위협하는 질병은 어떤 경우에도, 누구에게도 환영 받을 수는 없다. 차방전 없이 약국에 가서 가장 쉽게 구입할 수 있는 약이 감기약이다. 하지만 아무리 흔한 병이고 치료 방법이 다양하게 개발되어 있다고 해도 감기는 친근하면서도 무서운 질병이다. 각종 보험 상품으로 대비할 수 있고, 현대 의학이 정복했다고 하는 암 역시 여전히 듣기만 해도 고개를 내젓게 된다. 그러니 예방도, 치료도 어려운 인류의 난제인 AIDS에 대한 우리의 태도나 마음이 긍정적이기 어려운 것은 당연한 일일지 모른다.