• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.38-47
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• 2020

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.124-130
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• 2018

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.350-350
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• 2005

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.503-503
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• 2005

• Korean Journal of Health Education and Promotion
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• v.10 no.2
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• pp.11-21
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• 1993

Recently the structure of disease is changing its form into chronic disease. Taking into consideration this, the health care system doesn't cope with this tendency. With the health care system for acute disease, it is difficult to decrease medical care cost. At this point, Health education like primary health care can reduce risk factors and possibilities of occurrence of disease. This can cut off the medical insurance finance further more cuts off the rates of insurance cost. This is why health education is the principle part of medical insurance service. Though the law shows health education must be executed in the field of Medical insurance, still it is not enough. In order to carry out health education in the medical insurance organization, the efforts we should make are as follows: 1. Recognize the importance of health education. 2. Set the clear goals in health education. 3. Organize health education system. 4. Train health workers. 5. Systematize health education service. 6. Reform the medical insurance system. 7. Evaluate the effect of health education and practice the model.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.4
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• pp.213-228
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• 2022

This paper investigates the association between key corporate governance characteristics and the performance of general insurance businesses listed on the Saudi stock exchange (TADAWUL). The methodology for the study is based on a pooled data collection for 11 Saudi general insurance companies from 2011 to 20. The linear regression model and the logarithm regression model are suggested to assess the relationship between performance and corporate governance characteristics. The dependent variable is firm performance measured using ROA, ROE, and Tobin's Q. The independent variables are corporate governance variables consisting of a complete set of board and audit committee characteristics. Insurer-specific control variables are introduced. The empirical results reveal that the characteristics of corporate governance influence the performance of insurance companies. In particular, the board size, board's tenure, the proportion of independent directors in the board, audit committee size, audit committee meeting frequency, and proportion of health insurance premiums have a positive impact. However, audit committee independence, size of the company, and proportion of reinsurance premiums have a negative impact on the performance of the Saudi general insurance companies. Finally, the empirical results indicated also that there is an unclear relationship between the performance and board meeting frequency, compensations of the Board, and the average age of the Board.

• Health Policy and Management
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• v.31 no.3
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• pp.261-271
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• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.13-27
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• 2021

Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.

• Health Policy and Management
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• v.11 no.2
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.96-110
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• 2021

Korea is faced with the challenge of adapting to the world's fastest - growing low birthrate, aging society, and low growth with low interest rate era. With low fertility and aging population, the factors of financial income of health insurance are decreasing, and the increase of public interest in health, high cost medical technology and the development of medicine are leading to increase expenditure of health insurance. In this study, I will examine the strengthen protection of health insurance, financial stabilization, and fairness of medical care. First, the present status and limitations of health insurance were identified through domestic policy report, domestic and foreign literature, and precedent research. Second, the foreign health insurance policy measures to stabilize the finances were examined separately. Based on this study, in order to maintain sustainable health insurance through reinforcement and financial stabilization of health insurance, the current financial income structure of health insurance must be renovated. It will be necessary to expand government subsidies and discover new tax revenues. In addition, a policy to save finances by reorganizing the medical bill payment system and medical delivery system will also be needed.