• Title/Summary/Keyword: 의료보장체계

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Effects of Private Health Insurance in National Health Care System (국민보건의료에 대한 민간의료보험의 영향고찰 : 의료서비스 이용만족을 중심으로)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.14 no.1
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    • pp.200-208
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    • 2014
  • This study analyze long debate issues by the analysis of existing studies and the effect of private health insurance in the satisfaction of health service utilization. Then make developmental role of private health insurance. The analysis results of literatures, high-income earners are more subscriptions and the poor people in health status are excluded. Thus, enable private health insurance has the potential to lead the polarization of people. The medical use of private health insurance subscriber is more than non-subscriber and is likely to result in additional expenditure spending of public insurance. The contribution of private health insurance on improvement of the health option is clear. However, is not clear the contribution on health care quality improvement and health service customer satisfaction. The contribution on the national health care system efficiency of private health insurance is not clear. Private health insurance in the satisfaction of health service utilization is on effect. In short, supplementary private health insurance is desirable in our country.

The Development Path of China's Private Health Insurance and Its Role in the Health Care System (중국 민간의료보험의 발전경로와 의료보장체계에서의 역할)

  • Jung, Kee Taig;Fan, Jian Cheng;Chen, Wan Yun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.423-436
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    • 2021
  • This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

Design of Health Warning Model on the Basis of CRM by use of Health Big Data (의료 빅데이터를 활용한 CRM 기반 건강예보모형 설계)

  • Lee, Sangwon;Shin, Seong-Yoon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.8
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    • pp.1460-1465
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    • 2016
  • Lots of costs threaten the sustainability of the national health-guarantee system. Despite research by the national center for disease control and prevention on health care dynamics with its auditing systems, there are still restrictions of time limitation, sample limitation, and, target diseases limitation. Against this backdrop, using huge volume of total data, many technologies could be fully adopted to the preliminary forecasting and its target-disease expanding of health. With structured data from the national health insurance and unstructured data from the social network service, we attempted to design a model to predict disease. The model can enhance national health and maximize social benefit by providing a health warning service. Also, the model can reduce the advent increase of national health cost and predict timely disease occurrence based on Big Data analysis. We researched related medical prediction cases and performed an experiment with a pilot project so as to verify the proposed model.

The Effect of Private Health Insurance on the Subjective Burden of Medical Expenses (민간의료보험 가입 여부가 본인부담 진료비의 주관적 부담 수준에 미치는 영향)

  • Hong, Jin Hyuk;Noh, Jin-Won;Park, Kisoo;Lee, Yejin;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.63-70
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    • 2017
  • Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

Design and Development of an EHR Platform Based on Medical Informatics Standards (의료정보 표준에 기반한 EHR 플랫폼의 설계 및 개발)

  • Kim, Hwa-Sun;Cho, Hune;Lee, In-Keun
    • Journal of the Korean Institute of Intelligent Systems
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    • v.21 no.4
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    • pp.456-462
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    • 2011
  • As the ARRA enacted recently in the United States, the interest in EHR systems have been increased in the field of medical industry. The passage of the ARRA presents a program that provides incentives to office-based physicians and hospitals adapting the EHR systems to guarantee interoperability with various medical standards. Thanks to the incentive program, a great number of EHR systems have been developed and lots of office-based physicians and hospitals have adapted the EHR systems certified by CCHIT. Keeping pace with the rapid changes in the market of healthcare, some enterprises try to push in to the United States healthcare market based on the experience acquired by developing EHR systems for hospitals in Korea. However, the developed system must be customized because of the different medical environment between Korea and the United States. In this paper, therefore, we design and develop an integrated EHR platform to guarantee the interoperability between different medical information systems based on medical standard technologies. In the developed platform, an integrated system has been composed by integrating various basic techniques such as data transmission standards and its methods, medical standard terminologies and its usage, and knowledge management for medical decision-making support. Moreover, medical data can be processed electronically by adapting an HL7 interface engine and the terminologies for exchanging medical information and the standardization of medical information. We develop SeniCare, an EHR system for supporting ambulatory care of the office-based physicians, based on the platform, and we verify the usability of the platform by confirming whether SeniCare satisfies the criteria of "meaningful use" issued by CMS or not.

Critical Assessment of Productive Welfare and Several Policy Alternatives (생산적 복지정책의 평가와 향후 정책과제)

  • Cho, Woo Hyun
    • Journal of Labour Economics
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    • v.24 no.2
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    • pp.163-196
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    • 2001
  • This paper is a critical assessment of 'productive welfare policy' of the Kim Dae-jung adminstration and I tried to make several recommendations as alternatives. Quite contrary to concept of 'productive' welfare, which promotes less government intervention and more market-friendly approach, the Kim Dae-jung adminstration seems to have been moving in the opposite direction. As alternatives, I suggested i) work-fare rather than cash assistance, ii ) Employment Insurance Account to cover non-regular workers, iii) Medical Savings Account for minor medical services to reform medical insurance, and iv) enhancement of labor market flexibility by abolishing mandated retirement allowances in Korea I finally proposed the tuition and fellowship support program to the low-income group to enhance their economic status in a knowledge-based society.

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2006년 사회복지예산, 사회양극화 해소 못해

  • Jwa, Hye-Gyeong
    • Social Workers
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    • no.11 s.43
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    • pp.14-17
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    • 2005
  • 2006년 사회복지 · 보건분야 재정지출이 55조원 규모로 정부 총지출 221조원에서 복지재정이 차지하는 비중이 25%에 이른다고 발표되었다. 정부예산정책처에 따르면 2006년 보건복지부 소관 예산은 10조3,88억 원으로 2005년 비해 12.7% 증가하여 이는 정부 예산 증가율의 2배에 해당된다. 그러나 이는 과거 ‘SOC분야’의 주택부문이 복지분야로 분류체계가 변하면서 발생한 통계적 수치 변화에 불과하다. 2006년 기준으로 12조 1,496억 원 규모의 건설교통부 소관 주택부문 재정이 복지 분야로 포함되었으며, 이로 인해 2006년 예산이 획기적으로 늘어난 것처럼 보이는 것일 뿐 사실상 사회복지 · 보건 분야 재정지출은 12조1,496억 원을 제외하면 42조5,042억 원이다. 정부는 이를 통해 국민기초생활보장의 내실화의 차상위 빈곤계층 지원을 통한 사회안전망의 확충, 저출산 · 고령사회에 대비한 투자 확대 및 공공보건의료 기반을 강화해 ‘사회양극화’를 해소하겠다고 하고 있지만, 여전히 소득보장 기능이 미흡하고 지역 간 복지 불평등 문제를 심화시키며, 재원조달방안이 없는 등 여러 문제점을 안고 있다.

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Organisation des Rettungsdienstes in Deutschland (독일의 응급구조업무의 조직)

  • Kim, Ki Young
    • Proceedings of the Korean Society of Disaster Information Conference
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    • 2015.11a
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    • pp.300-302
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    • 2015
  • 독일의 응급구조업무의 조직은 독일 기본법(GG) 제30조, 제70조에 따라 오로지 연방부들에게 있다. 유럽 연합은 기술적 조직적 통일성과는 별도로 각각의 국민들의 건강보호의 일부분으로 응급구조의 조직과 재정에서 상당히 광범위하게 재량을 인정하고 있으며 이에 따라 유럽연합의 시스템과 정책들의 입법적 조화를 사실상 포기하고 있는 실정이다. 독일연방주들은 자신들의 주응급구조법률(LRDG)에서 응급구조업무의 보장을 일반적으로 재차 지방자치단체(주 근교도시중심)에게 독자적인 업무로서 인정하고 있다(가령 슐레비히 홀스타인주 응급구조법(RDGSH) 제6조). 이러한 주들은 응급구조를 자신의 관할지역에 대해 준비하고 스스로 운영하거나 운영통제할 수 있는 구조목적의 단체들(RZV)과 공동협력을 할 수 있다. 각각의 업무능력과 법적인 기준에 따라 구조 목적의 단체들(RZV)은 자신의 이름으로 응급구조를 운영하거나 하나 또는 다수의 기관(공공 구조서비스 혹은 사설 구조서비스)에게 시행을 위임할 수 있다. 이러한 측면에서 본 연구에서는 독일의 경우 의사가 직접 현장 의료를 담당하고 있다는 점에서최근 입법을 통해 응급구조사의 교육과정을 개편하고 있으며, 질적 향상을 통해 응급의사와 응급구조사의 권한범위에서 독일 응급구조사의 권한확대가 시도되고 있다는 시사점을 도출하고 있다.

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Factors Associated with Health Service Utilization of the Disabled Elderly in Korea (장애노인의 의료이용에 영향을 미치는 요인)

  • Jeon, Boyoung;Kwon, Soonman;Lee, Hyejae;Kim, Hongsoo
    • 한국노년학
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    • v.31 no.1
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    • pp.171-188
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    • 2011
  • The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.

A Study on the Ageism and Age-integrated Perception of Healthcare Professional Groups with experience in treating elderly patients (노인의료전문가 집단의 연령주의 및 연령통합 인식에 관한 연구)

  • Oh, Hye In;Ju, Kyong Hee;Kim, Ju Hyun
    • Korean Journal of Family Social Work
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    • no.61
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    • pp.59-91
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    • 2018
  • Using a Consensus Qualitative Research approach, this study aimed to identify the ageism and explore age-integration as a solution of age discrimination that occurs during the delivery of medical services by nine healthcare professionals who have experience in treating elderly patients. There were two-sided confession has shown by health care professionals about the Ageism. They reported that they don't discriminate by age. However, They also appealed an inconvenience due to the elderly. There were real Ageism in the Healthcare Professional site as a way of Unsuitable care, elderly alienation and dependence on caregivers, polarization of medical service and double discrimination against poor elderly. They found it difficult to offer age integrated health care as a means to mitigate or solve. However they have sought to break barriers to communication, provided a comfortable environment not only for senior citizens but also for all others, and have diversified institutional and service standards. To ensure the healthy life and proper medical service of the rapidly increasing elderly patients, we proposed to do critical review of the factors in the Korean medical system that accelerate the Ageism, reorganization of the health care system for the poor elderly, including the curriculum associated with age-integrating within the health care professional education system, raising the Geriatric Medical Service and the relating professionals and improvements in perception of the health care domains for the elderly and older adults.