• 한국주거학회:학술대회논문집
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• 한국주거학회 2009년도 추계학술발표대회 논문집
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• pp.121-125
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• 2009

The nursing-care insurance system started in April, 2000 in Japan. It was a kind of business opportunities for a lot of private entrepreneurs. They came into this care service business from another type of business rapidly. They opened the pay nursing homes with 24 hour nursing. However, the expense load of the nursing-care insurance system was large, local governments started controlling on total numbers of facilities with 24 hours nursing in 2006. So the group houses besides the pay nursing home without nursing care are paid to attention. The pay nursing home has been often managed by the nursing business. Most of the group houses are managed by community based NPO. This study is a case study by the visit and the interview form for one of the group houses. The group house "Shalom Tsukimino" in Kanagawa started operations comparatively at early time among them. Through the study we recognized that a lot of people were helping the NPO as a community service. So they can manage the group house and people who live there get the services with low cost. They show that they separate residence and nursing and use the community service efficiently. We can find a new direction in this case for the life in elderly.

• 지역사회간호학회지
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• 제32권3호
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• pp.356-367
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• 2021

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

• 대한간호학회지
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• 제42권2호
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• pp.236-247
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• 2012

Purpose: Purposes of this study were: evaluation of family burden of caring for elders who receive long term care services, and examination of differences in burden before and after the introduction of long term care service in Korea. Methods: Data were collected by questionnaires from 416 caregivers of elders who were registered with the Long Term Care Insurance Corporation in six cities. Data were collected in September, 2010 and analyzed using descriptive statistics, paired t-test, and ANOVA with the Scheffe test, and stepwise multiple regression. Results: Family burden decreased significantly after longterm care service was initiated. Subjective burden decreased from 2.93 to 2.69 (t=11.78, $p$<.001), and objective burden, from 3.40 to 3.10 (t=12.73, $p$<.001). Stepwise multiple regression analysis revealed that factors affecting subjective burden were family relations (F=13.60, $p$=.003), age (F=5.47, $p$=.019), job (F=6.98, $p$=.008), and education (F=4.59, $p$=.032), and that factors affecting objective burden were living together (F=17.66, $p$<.001), job (F=13.34, $p$=.003), monthly income (F=6.61, $p$=.010), and type of service (F=6.62, $p$=.010). Conclusion: The results of this first study to investigate caregiver burden after the Korean Long-term Care Insurance System was begun provide positive information for the development of strategies to decrease family burden in long term care.

• 보건행정학회지
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• 제30권2호
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• pp.253-262
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• 2020

Background: The public health care system of a country is shaped and driven by its historical background as well as social, economic, and cultural structures. This study sheds light on the unique features, strengths, and weaknesses of the health insurance systems of South Korea (Korea) and Peru. Methods: The capacity mapping tool was used to explore the Korean and Peruvian population and geographical structures; health insurance laws, regulations, and policies; payment systems; eligibility and contribution collection; and long-term care insurance. Results: The study found that the Korean government took the lead in integrating multiple insurers into a single-payer system in an effort to reinforce and stabilize its health insurance system in 2000. Peru has been developed mixed model such based on taxes and contributions, to address a gap between different social classes. Peruvian government developed a two-axis system, one for low-income earners, financed by taxes, and another financed by contributions paid by workers and government officials in the formal sector. Peru has introduced many variations to its fee payment and insurer systems, target population, and coverage scope, and maintains its health insurance system accordingly to this day. Conclusion: The current study provides observation of the Health Insurance System in two different countries and helps to understand possible ways to improve the health insurance system in both countries. Based on this study, Peru will be able to see how its system differs from Korea's and benefit from the related policy implications.

• 보건의료산업학회지
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• 제8권4호
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• pp.187-197
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• 2014

The purpose of this study was to examine the influence of long-term care insurance(LTCI) settlement on life satisfaction of female caregivers for the elderly. In September of 2013, we conducted a survey of 300 female subjects over 65 years old living in Jeonju. For empirical verification, ${\chi}^2$, t-test and regression under control of socio-economic variables were applied to determine whether LTCI settlements changed the level of life satisfaction of female caregivers. First, the results showed that caregivers who were not covered by LTCI had higher healthy life satisfaction than those covered with LTCI. Second, life satisfaction of female caregivers is higher when income and education levels are higher. Third, LTCI settlement did not affect five sub factors of caregivers' life satisfaction. The results suggested that LTCI policy should cover not only the insured but also caregivers'physical and mental aspects.

• 한국주거학회논문집
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• 제25권2호
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• pp.99-107
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• 2014

This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

• 보건의료산업학회지
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• 제12권3호
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• pp.13-26
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• 2018

Objectives: This study investigated how Korean daily newspapers frame the present government's health insurance coverage expansion policy, Moon Jae-in Care. Methods: A contents analysis was conducted to construct news frames represented in the four Korean daily newspapers' editorials and columns on Moon Jae-in Care during from April 2017 to April 2018. News text was classified into three different layers of frames: expressive element, narrative structure, and implied values. Results: The analysis revealed that the frequency of narrative frames was as follows: health system improvement (20.8%), public burden (14.6%), opposition by doctors (14.6%), and populism (12.5%). The financial sustainability accounted for 41.7% of the value frame, followed by procedural legitimation (18.8%), and coverage expansion (16.7%). The results also revealed that reported frames were different among newspapers: Chosun Ilbo tended to report in a negative tone, while Hankyoreh shinmun and Kyunghyang shinmun used a positive tone. Conclusions: This finding suggests that there are salient framings in reports on Moon Jae-in Care. Based on the results, the government needs to present a detailed financing plan on Moon Jae-in Care in detail. I discussed another implication of media frames results.

• 보건행정학회지
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• 제31권4호
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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.

• KDI Journal of Economic Policy
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• 제30권2호
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• pp.99-128
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• 2008

민간보험은 공적보험과 보완적인 관계를 형성함에도 불구하고 우리나라의 민간보험은 소득계층에 따른 접근성 차이로 인한 사회적 불평등, 도덕적 해이로 인한 공적보험 재정악화 등의 우려를 낳고 있다. 그러나 이에 관한 실증적 분석은 그간 이루어지지 못하여 정책적인 방향을 정립하는 데 장애가 되어 왔다. 본 연구는 건강보험공단, 심사평가원, 민간보험사, 행정자치부 주민등록세대정보 등의 관련 정보를 종합하여 이에 대한 실증분석을 시도했다. 그 결과, 우리나라의 민간보험 가입률은 전 국민의 64%에 달하고 있으며, 고소득층과 저소득층 간에 민간보험 가입률의 차이가 나타나지 않았다. 이는 공적보험의 보장성이 미흡한 상황에서 저소득층 역시 갑작스런 의료지출에 대비하고 있으며, 민간보험이 의료접근성의 계층화를 초래하지 않고 있다는 것을 시사한다. 또한 민간보험 가입자는 평균적으로 미가입자에 비해 의료이용량이 높지 않았으며, Two-Part Model을 통해 다양한 변수를 통제했을 경우에도 동일한 결과가 나타났다. 연령대에 따른 차이로 미루어 이러한 결과는 노동시장과 연관된 한시적인 성격일 것으로 추측되나, 현재로서는 민간보험 가입에 따른 도덕적 해이가 강하게 나타나고 있다는 근거는 발견되지 않았다.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.20-27
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• 2016

Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.