• Title/Summary/Keyword: 지역의료보험

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Analyses on the Use Pattern of a General Hospital - With Cases of Seoul-KyungKi and DaeGu-KyungBuk Area- (민간의료보험 도입 활성화 방안도출을 위한 지역별 인식 비교 분석 -서울경기와 대구경북 지역을 중심으로-)

  • Park, In-Suck;Kang, Chang-Yeol
    • The Korean Journal of Health Service Management
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    • v.3 no.2
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    • pp.65-75
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    • 2009
  • This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on a general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization. And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea. And it was understood that most of residents within a distance of 40 minute by the public transportation were using. Although there are restrictions that the analyses were carried out for a general hospital in a province, the findings of this study can be considered a generalized model for the management of provincial general hospitals when we consider the current circumstance that the diagnosis and treatment are carried out by provincial medical institutions primarily for patients in general within the province, along with implications that any general hospital in Korea should be equipped with the facilities, equipments and human resources under the Medical Treatment Act.

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Factors Influencing the Regular Oral Check-Ups: Based on the Data of the 2014 Korea National Health and Nutrition Examination Survey (우리나라 경제활동자의 구강검진 수진 영향요인: 국민건강영양조사 제6기 2차년도(2014) 자료를 바탕으로)

  • Kim, Dong-Hwi;Seo, Young-Joon
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.323-332
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    • 2017
  • This study aimed to investigate the factors influencing the decision on whether to receive regular oral check-ups among the national health insurance beneficiaries with income and aged over 20 years in Korea. This was a cross-sectional study, using the data from the 2014 6th Korea National Health and Nutrition Examination Survey (KNHANES VI-2), conducted by the Korea Centers for Disease Control and Prevention. The final sample included 2,843 subjects who participated in the health examination survey and oral check-ups. The IBM SPSS Statistics ver. 20.0 was used for the statistical analysis, based on the complex sampling design. The Rao-Scott chi-square test was used to verify the difference in the distribution of independent variables with regard to oral check-ups. The binary logistic regression analysis was used to determine the influencing factors. The ratio of beneficiaries who received oral check-ups was less than half of those who received medical examinations. The Rao-Scott chi-square test, revealed significant differences in the age group (p<0.05) of the predisposing factors, toothache within a year (p<0.001), untreated dental caries (p<0.001) of the need factors, personal income level (p<0.001), educational level (p<0.001), type of medical insurance (p<0.001), and private health insurance (p<0.01) of the enabling factors. In the binary logistic regression analysis, factors influencing oral check-ups were age group, personal income level, educational level, toothache within a year, and untreated dental caries. These findings show a variety of factors influencing the utilization of regular oral check-ups.

The Information Effect of Medical Examination on Individual Health Promotion Behaviors: Evidence from Korea (개인의 건강증진행위에 대한 건강검진의 정보효과: 한국의 경우를 중심으로)

  • Lim, Jae Young
    • KDI Journal of Economic Policy
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    • v.33 no.1
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    • pp.73-91
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    • 2011
  • This paper demonstrates empirically that individuals who monitor indicators of their current cardiovascular health status by undergoing medical examinations are more likely to invest in their own health than those who do not observe such monitoring protocols. Using data from the 2001 National Health and Nutrition Examination Survey of Korea in a structural econometric model, this paper attempts to control the endogeneity problem inherent to the individual decision as to whether to undergo medical examinations, and provides estimation results showing that increased individual health awareness via medical examinations exerts a statistically significant positive effect on health investments. From the policy perspective, the estimation results of this paper may provide a rationale supporting the health policy of free provision of health examination services to the insured via National Health Insurance.

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A Study on the Determinants of Convalescent Rehabilitation Medical Service Needs at Regional Level (지역별 회복기 재활 의료서비스 필요도 결정요인 분석 연구)

  • Jung Hoon Kim;Heenyun Kim;Yongseok Choi;Hyoung Sun Jeong
    • Health Policy and Management
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    • v.33 no.1
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    • pp.40-54
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    • 2023
  • Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

Strategies for Public Health Service Development in the Times of Local Autonomy (지방자치시대의 공공보건사업 발전 전략)

  • 박정한
    • Health Policy and Management
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    • v.12 no.3
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    • pp.1-22
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    • 2002
  • Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

A Study on Current Situations of Patients with Health Insurance at the Dental Center of Local Health Centers in Rural Areas (비도시지역 건강보험환자의 보건소 치과 의료서비스 이용실태에 관한 조사연구)

  • Woo, Hye-Hong;Lim, Soon-Hwan
    • Journal of dental hygiene science
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    • v.5 no.1
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    • pp.7-12
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    • 2005
  • This study was conducted to compare and analyze 877 cases of health insurance claims from the first half of 1999 requested to the dental centers of local health centers in rural areas and 510 identical cases from the first half of 2003. It was purposed to understand the trend of rural residents' visits to local health centers and to use the collected data as the basis needed for the vitalization of local dental cares to efficiently improve Korean citizens' dental hygiene. The results were shown as below: 1. The sexes of the visitors were fairly evenly distributed for each year. 2. Among the total of 39 types of diseases treated, 1999 had 31.9% of visits for 'Gingivitis and periodontal diseases' with 25.4% from ages between 10 and 19, for statistically attentive results. On the other hand, 2003 had 46.5% of visits for 'Oral examination' with 52.9% from ages between 0 and 9, for statistically attentive results. 3. For the distribution of age groups, majority in 1999 made visits for dental caries, gingivitis and periodontal disease, whereas majority in 2003 were for oral examination, dental caries, gingivitis and periodontal disease.

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Management Strategies for Medical Expenses Depending on Type of Diseases for Patients of Seafarers Insurance - Focused on Busan - (선원보험 수진자의 상병유형에 따른 진료비 관리방안 - 부산지역을 중심으로 -)

  • Park, Eun-Ha;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.10 no.4
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    • pp.1-11
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    • 2016
  • Objectives : The aim of this study is to investigate the actual condition of the occurrence and recovery of medical expenses through seafarers insurance and to provide basic data that will be helpful in the establishment of efficient hospital management strategies for medical expenses of insurance companies depending on the type of seafarers insurance. Methods : Three general hospitals located in Busan, Korea, were selected, and seafarers insurance claim data was collected from January 1, 2012 to December 31, 2013(24 months) and analyzed. There were 5,490 cases in total. Results : There was a significant difference in the distribution of disease incidence, accrued medical expenses, reimbursement of medical expenses, and the actual condition of medical receivables depending on the insurance company. Conclusions : Therefore, differentiated payback strategies for medical expenses are needed that consider the various seafarers insurance companies and their treatment characteristics.

Regional Variations and Related Factors of Mastication Difficulty Rate among the Korean Elderly (우리나라 노인의 저작불편 호소율의 지역 간 변이와 관련 특성)

  • Kim, Ranhee;Kim, Ji Man;Park, Chong Yon;Park, Keun-Young;Lee, Changwoo;Shin, Euichul
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.100-105
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    • 2018
  • Objectives: The purpose of this research is to investigate regional variations of mastication difficulty rates in the elderly over 65 in 229 primary autonomous districts in Korea and explore relevant characteristics. For the research data, local community health survey conducted in 2015 and data from Ministry of the Interior and Safety, Ministry of Health & Welfare, National Health Insurance Service and Statistics Korea were used. Methods: Frequency analysis was conducted for general characteristics and mastication difficulty rates of each region, and distribution of mastication difficulty rates was displayed for each town, city and province by mapping them. Extremal quotient (EQ), coefficient of variation (CV) values were calculated for regional variations, and logistic regression analysis was performed to reveal the relationship between each independent variable and mastication difficulty rates. Results: The average of standardized mastication difficulty rate was 46.78%, and regional variations were significant with EQ 3.46, CV 0.18. Characteristic factors that have significant effects on mastication difficulty rate included sex ratio, elderly population and the number of dentists per 10000 people. Conclusion: As a result, there were variations among mastication difficulty rates in 229 primary local governments across the country, and the distribution of health care resources by the characteristics of the local environment by region affected mastication difficulty rates. Accordingly, it is required to provide political supports to overcome regional inequality of oral health levels and develop cooperative system between local governments and local dentists.

Factors affecting the Length of Stay in Patients with Total Knee Arthroplasty (슬관절 전치환술 환자의 재원일수에 영향을 주는 요인)

  • Lee, Hye-Seung;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.201-208
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    • 2020
  • The purpose of this study was to analyze the claim data of Health Insurance Review & Assessment Service to determine what factors affected the length of stay in patients aged 65 and older and undergoing total knee arthroplasty due to the principal diagnosis of gonarthrosis by the type of medical institutions. As a result of making an analysis, gender, age, medical security type, severity, residential area and the number of sickbeds were identified as the factors that influenced the length of stay in each type of medical institutions. At this point in time when an increase in the elderly population triggered by population aging and another subsequent increase in medical expenses put a heavy strain on household and national economy, it's necessary to consider how to shorten the length of stay and how to ensure the efficient management of sickbeds based on the findings of this study. In addition, this study is of significance in that it could be used as basic data on quality life-care for elderly patients by the introduction of a systematic management system geared toward lessening patient burden for medical expenses.

The Ratio of Medical Aid over Health Insurance of Age Adjusted Mortality Rate of Tuberculosis and Related Factors (의료보장유형에 따른 연령표준화 결핵 사망률비와 관련 요인)

  • Na, Baeg-Ju;Kang, Moon-Young;Hong, Jee-Young;Kim, Eun-Young;Kim, Keon-Yeop;Lee, Moo-Sik;Yang, Sang Kyu
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.9-20
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    • 2006
  • Objectives: This study was aimed at investigating the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors. And we want to compare the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Methods: In order to compare, the data was referred to National health insurance center for affirming the insurance type of the dead. And age adjusted mortality rate of tuberculosis of each insurance type was analyzed by whole country and the provinces. Related factors of the provinces were gathered from public statistic books. We analysed correlation study between the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Results: Major findings were as follows 1. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis was 5.6. And the ratio was relatively high at 40-60 ages. 2. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis by the province was varying. And the factors that were financial independence, crowdedness, percent of people on medical aid, population size served by each public health center, number of hospital by a million peoples have correlated with increment of the ratio. Conclusions: As a consequence of tuberculosis control, the ratio was high. Thus this finding suggests that medical utilization and preventive behavior, environment of tuberculosis patient are under handicapped condition. Especially large cities like metropolitan area who have high financial independence, high population density, high percentage of medical aid peoples have high ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis. There is need for additional and systematic research on the attitude or tendency toward medical services(inc1uding preventive services) utilization of medical aid tuberculosis patients.

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