• Title/Summary/Keyword: Health Insurance Corporation

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Comparison of Medical Care Patterns of Hypertensive Patients between Rural and Urban Areas (도시와 농촌지역 고혈압 환자의 의료기관 이용 형태 비교)

  • Lim, Bu-Dol;Chun, Byung-Yeol;Park, Jung-Han;Lim, Jung-Soo
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.15-27
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    • 2003
  • Objectives: This study was conducted to compare the medical care patterns of hypertensive patients between rural and urban areas. Methods: We selected one rural county(Region A where there were 19 public health centers; one health center, 8 health sub-centers and 10 community health posts) and two urban districts(Region B and C where there was no health sub-center and community health post) in Daegu city. Region B had similar socioeconomic characteristics with rural county A while region C had different characteristics. The medical insurance records of 14,422 incident patients (2,501 in region A, 4,873 in region B and 7,048 in region C) with diagnostic code of hypertension from September 1998 to August 1999 were reviewed. Incident patient was defined as a patient who had no record of medical fee claim for hypertension to the national health insurance corporation in past 6 months and visited a medical facility for hypertension for the first time. The data for annual visit days, annual prescription days and annual total medical expenses were abstracted. The medical care pattern was categorized by the number of annual visit days and prescription days. The most proper care group was defined as the patient who visited 6-15 days with 240 prescription days or more in a year. Results: The type of medical facilities for the most visit was clinics, 373.% and it was followed by general hospitals, 28.2%; public health centers, 24.7%; and hospitals, 9.8% in region A(p<0.05). In region B, it was clinics, 63.1% and followed by general hospitals, 27.6%; health center, 5.2%; and hospitals, 4.1%(p<0.05). In region C, it was clinics, 53.8% and followed by general hospitals, 35.0%; health center, 6.3%; and hospitals, 4.9%(p<0.05). Annual mean total medical expenses per patient was highest in region C(won195,993) and followed by region A(won191,683) and region B(won178,713). The proportion of the most proper care group was 7.7% in region A, 5.2% in region B and 6.7% in region C(p<0.05). According to the type of medical facilities for the first visit, the proportion of the most proper care group was highest(14.7%) in the patients of public health centers, and it was followed by general hospitals, 8.8%; clinics, 3.6%; and hospitals, 2.0% in region A(p<0.05). In region B, it was highest in general hospitals, 9.7% and followed by hospitals, 4.0%; health center, 3.6%; and clinics, 3.4%(p<0.05). In region C, it was highest in general hospitals, 10.1% and followed by clinics, 5.2%; hospitals, 4.1%; and health center, 3.1%(p<0.05). Conclusions: The proportion of proper care for hypertension was higher in rural area and it was attributed to the care of health center, sub-centers and community health posts which appeared to follow patients better than hospitals and clinics.

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The reform of inspection of adult social care market in the UK and policy suggestions for long-term care in South Korea (영국 성인돌봄서비스 시장에 대한 감독 개혁과 한국 장기요양의 시사점)

  • Chon, Yongho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.203-210
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    • 2018
  • The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

A Study on the Efficiency of Day Care Facilities for the Elderly in 22 Cities and Counties in Jeonnam

  • Seong-Bae Jeong;Yeon-Ju Lee
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.10
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    • pp.247-256
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    • 2023
  • This study was conducted with the purpose of suggesting alternatives for the efficient operation of senior day care facilities in 22 cities and counties in the Jeonnam region by analyzing the efficiency of senior day care facilities. The analysis data for the study used the National Health Insurance Corporation's long-term care insurance for the elderly (2022), the Input variables were the number of facilities, the number of workers, the number of affordable, and the number of senior long-term care insurance recipients and the Output variables were the the number of users. As a result of the analysis, CCR was most efficient in Goheung-gun, Gokseong-gun, Gwangyang-si, Boseong-gun, Yeongam-gun, and Jindo-gun, BCC was most efficient in Goheung-gun, Gokseong-gun, Gwangyang-si, Gurye-gun, Damyang-gun, Boseong-gun, and Jindo-gun, and SE was most efficient in that order: Jindo-gun, Gokseong-gun, and Gwangyang-si. It turned out to be a super efficient area. In the contribution analysis, the number of affordable and workers variables were found to be variables that had a large impact on efficiency contribution. In the improvement potential analysis, the number of facilities variable was found to be a variable that had a significant impact on efficiency. Therefore, for the efficient operation of senior day care facilities, we suggest adjusting supply and demand, such as the number of facilities and affordable, and suggest that training programs to strengthen the expertise of workers who contribute greatly are required.

Development of a Community-based Preventive Health Care Model for the Elderly in Korea through the Evaluation of a Japanese Counterpart (일본의 노인건강관리체계 검토를 통한 한국 지역사회노인 예방 건강관리 방안모색 연구)

  • Lee, In-Sook
    • Perspectives in Nursing Science
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    • v.7 no.1
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    • pp.10-22
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    • 2010
  • Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

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Effects on the Psychosocial Health Status of Job Stress and Job-related Characteristics among Clerical Public Officers using the Structural Equation Model (구조방정식모형을 이용한 사무직 공부원의 직업관련 특성과 직무스트레스가 사회심리적 건강상태에 미치는 영향)

  • Cho, Young-Chae;Kwon, In-Sun;Bae, Nam-Kyou;Park, Jae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2169-2177
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    • 2010
  • The effects of job related factors on psychosocial health status were examined by taking job stress into account. The self-administered questionnaires were performed, during the period between Oct. 1st, 2009 and Nov. 30th, 2009, to 805 individuals in the service of general administration located in Daejeon City. Causal relationships between job related factors, job stress, and, psychosocial health status were examined by structural equation model. The main finding as follows: For correlations of such indices of psychosocial health status as PWI and MFS with various studied items, all of these two indices were found to be in a negative correlation with the job position, job career, satisfaction in job life, autonomy of job, supervisors support and coworkers support, whereas in positive correlation with the experience of sick absence per year and job demand. With the analysis of structural equation model, the degree of job stress factors was more influential on the level of psychosocial health status than job related factors in such a manner as that the greater the job stress, while the lower the job related factors, the higher the psychosocial health status(PWI and MFS). Moreover, it was found to have the inter-relational effects that the greater the job related factors, the lower the job stress factors. Thus the effective strategy for stress and fatigue symptoms reduction among governmental employees requires additional programs focusing on innovated job specifications.

Cost-benefit Analysis of Health Screening Test for the Insured (피보험자 건강진단의 비용-편익 분석)

  • Yu, Seung-Hum;Sohn, Myong-Sei;Cho, Woo-Hyung;Park, Eun-Cheol;Lee, Young-Doo;Lee, Kyu-Sik;Chun, Ki-Hong
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.248-258
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    • 1989
  • As a result of cost-benefit analysis by making a macroscopic approach to the health screening projects conducted 4 times since 1950 for the insured people of the Korea Medical Insurance Corporation, the following conclusions were reached. 1. The direct costs put into the health screening project, and the time costs which were paid by examinees or calculated in terms of social costs have been estimated. The results is that the lowest estimation was 10,337 million won and the highest 15,141 million won when a minimum of 1.5 hours of time spent and a maximum 4 hours were applied. 2. In terms of the psychiatric benefits, the lowest estimation was 5,341 million won while the highest was 5,585 million won. 3. In terms of the benefits for each kind of diseases, the lowest estimation of 37,188 million won and highest estimation of 74,383 million won have been calculated for the liver diseases. And for the cardiovascular diseases, the minimum estimation was 14,475 million won while the maximum was 20,532 million won. In case of pulmonary tuberculosis, with external effect benefits being included, the estimation ranged from the minimum of 1,649 million won to the maximum of 1,832 million won. And the estimation of benefits for diabetes mellitus and renal diseases ranged from 89 million won to 92 million won and from 4,567 million won to 7,598 million won respectively. 4. In comparing costs and benefits, as a results of comparing each highest and lowet estimation a range of minimum 46,708 million won and maximum 98,071 million won of benefits has been gained.

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Health and Economic Burden of Major Cancers Due to Smoking in Korea

  • Oh, In-Hwan;Yoon, Seok-Jun;Yoon, Tai-Young;Choi, Joong-Myung;Choe, Bong-Keun;Kim, Eun-Jung;Kim, Young-Ae;Seo, Hye-Young;Park, Yoon-Hyung
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1525-1531
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    • 2012
  • Cigarette smoking is one of the most important public health concerns in Korea and worldwide. A number of studies have been conducted to measure the health and economic burden of smoking, but these did not reflect recent changes such as the decrease in smoking rate and the increase in the incidence of cancer. The purpose of this study was to provide up-to-date estimates of the health and economic burden of cancer caused by smoking and to compare the results with those of previous studies. Cancer-related burden was assessed with nationally representative data such as claims data from the National Health Insurance Corporation, and cause of death records from the National Statistical Office and the Korea Health Panel. We determined the smoking-attributable burden by multiplying the smoking-attributable fraction by the total burden. As a result, the burden of major cancers due to smoking was found to be substantial despite a recent sharp decrease in smoking by the Korean population. The total economic cost reaches $2,234.0 million in males and $870.0 million in females. Also, the health burden of cancers due to smoking is 2,038.9 disability adjusted life years (DALYs) per 100,000 individuals in men and 732.2 DALYs per 100,000 individuals in women. Among all cancers, cancers of the trachea, lungs and bronchus are the leading causes of health and economic burden. The huge burden caused by cancers linked to smoking makes it imperative that adequate policies to decrease the prevalence of smoking be developed, particularly considering the recent increase in smoking rate among women.

Understanding Factors Associated with Unmet Need for Outreach Community Health Service among Older Adults in Seoul (노인 방문건강관리 서비스 미충족 영향요인: 서울시 찾아가는 동주민센터 사업을 중심으로)

  • Shon, Changwoo;Lee, Seungjae;Hwang, Jongnam
    • 한국노년학
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    • v.39 no.2
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    • pp.213-229
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    • 2019
  • The purpose of this study was to examine various factors influencing the needs of Seoul's newly implemented outreach community services for older adults, and to suggest the direction of the outreach community health services in Seoul. A multi-level regression was conducted using data collected by face-to-face interviews from 1,000 individuals aged 65 and 70 in 17 districts, where participated in the Seoul's outreach community services. The results demonstrated that socioeconomic status (higher income and living alone), health status (having multiple chronic conditions and depression, lower health literacy), limited experience of the outreach community services, and low government trust at the individual level were associated with higher unmet need for the community outreach services. In addition, shorter participation period of the outreach services and financial independency at the district level were associated with higher unmet need for the services. The findings from this study implies the need for improving the quality of services by focusing on vulnerable groups such as individuals with lower income and worse health status. In addition, the outreach community health services may need to target individuals aged 66 to increasing efficiency of the services through utilizing results of life-cycle health checkup by the National Health Insurance Corporation.

Relationships between obesity, blood and urinary compositions, and dietary habits and depressed mood in Koreans at the age of 40, a life transition period (만 40세 생애전환기 건강진단 수검자의 우울기분과 영양 생활습관 및 건강특성과의 관련성)

  • Chu, Ji Eun;Lee, Ji Min;Cho, Han-Ik;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.46 no.3
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    • pp.261-275
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    • 2013
  • This study was designed to investigate the relationships of depressed mood with obesity, blood and urinary compositions, and dietary habits in Koreans at the age of 40, a critical transition to the middle adulthood stage. A total of 27,684 people who have taken the Life Transition Period Health Examination at the Korea Association of Health Promotion in 2011 were divided into two groups; the depressed mood group (DG) and the non-depressed group (NG) according to results of the primary questionnaire for mental health. The results were analyzed using the health examination criteria of the National Health Insurance Corporation. Women and medicaid recipients showed higher incidence of depressed mood than men and health insurance subscribers. People with underweight in BMI or abdominal obesity showed correlation with depressed mood, while there was no significant relationship with metabolic syndrome. Regarding blood and urinary compositions, DG was related to a higher level of hemoglobin and lower levels of HDL-cholesterol and triglyceride, although the relationships diminished after adjustment for other confounder effects. According to dietary habits, more people in DG were categorized as a group for "Needs Much Improvement", and the odds ratio of the depressed mood showed a significant increase. Significant difference regarding the frequency of food items such as milk products, animal proteins, Kimchi, and fruits was observed between DG and NG. In addition, a higher portion of subjects in DG did not consume regular meals and various kinds of food. In conclusion, the depressed mood of 40 year-old adults was significantly related to underweight, higher waist measurement, and undesirable dietary habits. Results of our study can be applicable as a basic resource for development of effective nutrition counseling and education programs for improvement of mental health promotion during the critical transition to the middle adulthood stage.

Lifestyle and Metabolic Syndrome among Male Workers in an Electronics Research and Development Company (한 전자제품 연구소 남자 종사자들의 생활습관실천과 대사증후군의 관련성)

  • Myong, Jun-Pyo;Kim, Hyoung-Ryoul;Kim, Yong-Kyu;Koo, Jung-Wan;Park, Chung-Yill
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.331-336
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    • 2009
  • Objectives : The objectives of this study were to determine the relationship between lifestyle-implementation and metabolic syndrome in an electronics research and development company, and to provide a foundation for health providers of health management programs for setting priorities. Methods : From July 1 to July 16, 2008 we carried out a descriptive cross-sectional survey. Consecutive workers of one R & D company in Seoul, Korea (N=2,079) were enrolled in study. A checklist for lifestyle (from the National Health Insurance Corporation) consisted of questions regarding diet, drinking, smoking and exercise. After the survey, researchers obtained data from health profiles for metabolic syndrome(waist-circumference, triglycerides, HDL cholesterol, blood pressure and fasting blood sugar level). Lifestyle was recorded as good or not good. Statistical analysis of metabolic syndrome and the lifestyle of subjects was done using multiple logistic regression analysis. Results : The prevalence of metabolic syndrome in our study gropu was 13.3% (N=277). After adjustment for age, the adjusted odds ratios (odds ratio, 95% confidence intervals) for metabolic syndrome increased in proportion to the number of bad habits: two (1.72, 1.23-2.44), three (2.47, 1.73-3.56), and four (3.63, 2.03-6.34). Relative to subjects eating both vegetables and meat', the OR for 'meat' eaters was 1.66 (1.18-2.31). Compared with 'nonsmokers and ever-smoker', the OR for 'current-smoker' was 1.62 (1.25-2.10). Compared with 'Healthy drinker', the OR for 'unhealthy drinker' was 1.38 (1.05-1.83). Conclusions : Poor lifestyle was associated with an increased likelihood of metabolic syndrome. These findings suggest that lifestyle-based occupational health interventions for young employees should include a specific diet, smoking cessation, and healthy-drinking programs.