• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.270-279
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• 2011

This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

• The Journal of the Korea institute of electronic communication sciences
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• v.9 no.2
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• pp.203-209
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• 2014

The purpose of this study was to analysis of influence between of private health insurance and length of stay with cervical and lumbar simple sprain patients at Ubiquitous medical environment. They were diagnosed as having sprain of cervical and lumbar spine without neurological symptoms in hospitals and clinics from July 1, 2010 to February 29, 2012. This study was t-test, ANOVA and multiple regression analysis. The results were when the number of private health insurance was input as an independent variable, the subjects had one or two accidental insurances(${\beta}$=2.731, P=0.013), length of stay in beds was longer than they had no accidental insurance and when they had more than three ones(${\beta}$=4.991, P=0.000), length of stay was significantly longer. This study has a meaning in that it is domestic practical study which identified relationships between entry of private health insurance and length of stay.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.151-181
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• 2009

Im koreanischen Gesundheitsversicherungssystem spielt die soziale Solidarit$\ddot{a}$t Hauptrolle bei unterschiedlichen gesundheitspolitischen Entscheidungen. Daher wird manchmal vernachl$\ddot{a}$ssigt, dass auch die Qualit$\ddot{a}$tsverbesserung der Medizin und der Umfang der von der Krankenversicherung unterst$\ddot{u}$tzten medizinischen Leistungen wichtige Elemente der Krankenversciehrung sind. Um die letztere zwei Ideologien zu verwirklichen, soll insbesondere das Prinzip der Konkurrenz funktionieren k$\ddot{o}$nnen. Aber im koreanischen System hat die Konkurrenz fast gar kein Platz f$\ddot{u}$r sich. Auch das deutsche GKV (Gesetzliche Krankenversicherung)-system versucht die Sozialversicherung zu sein. Aber den deutschen Krankenversicherungssystem sieht es-speziell mit dem Vergleich vom Koreanischenzumindest viele unterschiedliche Funktionssysteme immanent zu sein. Zum einen tendiert die Einf$\ddot{u}$hrung des Gesundheitsfonds und vom Einheitlichen Beitragssatz die Sozialsolidarit$\ddot{a}$t zu verst$\ddot{a}$rken. Zum anderen tragen aber die Systeme von Zusatzbeitrag, Pr$\ddot{a}$mien und Wahltarife dazu bei, bessere Qualit$\ddot{a}$t der medizischen Leistungen zu garantieren und die Pr$\ddot{a}$ferenz von Patienten ernst zu nehmen. Es ist zwar nicht einfach vorauszusagen, zu welchen Ergebnissen diese Elementen f$\ddot{u}$hren. Aber die Funktion der unterscheidlichen Elementen, die die Konkurrenz motivieren konnen, zeigen schon viele Andeutungen f$\ddot{u}$r die Ver$\ddot{a}$nderung des korenischen Systems.

• The Journal of the Convergence on Culture Technology
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• v.10 no.3
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• pp.667-673
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• 2024

This study aims to diagnose the issues arising from the relationship between the out-of-pocket maximum in health insurance and private indemnity health insurance and propose policy tasks for institutional improvement. Through literature research, the study analyzed the damage to consumers caused by the non-payment of refunds exceeding the out-of-pocket maximum and the changing role of indemnity insurance due to the strengthening of health insurance coverage. The results confirmed that unilateral interpretation of insurance clauses and incomplete sales practices infringe upon consumer rights, and that insurance premiums do not decrease despite the reduction in coverage of indemnity insurance. Therefore, the study emphasized the urgency of institutional improvements such as rationalization of product structure, transparency of risk rate calculation, and reinforcement of consumer information provision, as well as the need for social consensus on the rational division of roles between health insurance and private insurance. This study is significant in that it provides policy implications for the developmental reorganization of the healthcare system.

• Journal of the Korean hospital association
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• v.13 no.11 s.119
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• pp.4-8
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• 1984

현대는 의료보험시대라 해도 과언이 아니다. 이는 의료보험제도가 건강한 삶을 유지하려는 모든이의 희구속에,의료에 대한 관심이 점점 고조되어 현대 생활의 한 부분으로서 정착되어가고 있기 때문이기도 하다. 그간 국민복지향상을 지향하며 발전해온 동제도가 시행과 더불어 많은 제도상의 문제점과 함께 새로운 변화를 야기시켜 오늘의 사회에 부각되고 있는것도 의료보험제도가 국민가자에게 미치는 영향이 어떠한가를 적라라하게 보여주고 있는것이라 하겠다. 본고는 이러한 견지에서 의료보험시대와 더불어 야기되는 문제점들을 고찰하고 나아가 동제도의 발전을 위한 바람직한 방향을 제시하고 있다,

• The Journal of the Korea Contents Association
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• v.22 no.1
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• pp.601-610
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• 2022

Although the number of people insured by private health insurance in Korea is steadily increasing, the household burden or the status of multiple purchasing for private health insurance has not been addressed. In this study, data of the 2011-2018 Korea Health Panel Survey was used to examine the purchasing trend of Korean households' private health insurance. Households with more than three private health insurance per household member were defined as the 'poly-purchases'. The logit model was applied to analyze factors associated with poly-purchase of private health insurance using 2018 cross-sectional data. From 2011 to 2018, the number of insurances purchased by Korean households increased (4.0 to 4.6), the number of insurances per capita increased (1.3 to 1.6), and the proportion of the poly-purchasing households increased (5.2% to 10.8%). As a result of logit analysis, the probability of poly-purchasing was increased when the household head was a woman, with a high level of education and income, and when the job of the household head was a service or sales. Poly-purchasing was less likely when the family was subsidized with Medical Aids and suffered with more chronic diseases. The results of this study serve basic evidence for establishing policies regarding private health insurance, such as establishing the relationship between public and private insurance.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Korean Journal of Social Welfare
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• v.12
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• pp.81-92
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• 1988

• The Journal of the Korean dental association
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• v.25 no.7 s.218
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• pp.650-650
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• 1987