• Research in Community and Public Health Nursing
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• v.32 no.3
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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.

• Health Policy and Management
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• v.31 no.4
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• pp.472-478
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• 2021

Background: Early identification of patients who are highly likely to develop severe illness among confirmed cases of coronavirus disease 19 (COVID-19) can be expected to lead to effective treatment. This study therefore aimed to determine whether the presence of nonalcoholic fatty liver disease (NAFLD) has an impact on the exacerbation of COVID-19 symptoms. Methods: The study used the Korean National Health Insurance claim data for treatment of COVID-19 patients in 2020. NAFLD includes nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The outcome variables used were hospitalization and the use of medical devices. Hospitalization was defined by a length of stay exceeding one day and the use of medical devices was defined as one or more uses of a ventilator or extracorporeal membrane oxygenation. Multivariable logistic regression analysis was performed to determine if there was a difference in the hospitalization and use of medical devices of COVID-19 patients depending on the presence of NAFLD. Results: The odds ratio of hospitalization was 1.059, indicating slightly higher odds of hospitalization for patients with NAFL or NASH compared to those without the conditions, but it was not statistically significant (0.969-1.156). On the other hand, the odds ratio of use of medical devices was high at 1.667 and was statistically significant (1.111-2.501). Conclusion: The study results found NAFLD to be a risk factor that can exacerbate symptoms in COVID-19 patients. Accordingly, it is necessary to identify NAFLD patients through preemptive screening and provide them with appropriate treatments.

• 한국노년학
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• v.30 no.1
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• pp.81-91
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• 2010

The purpose of this study was to test a validity and reliability of Cognitive Performance Scale(CPS), a cognitive measure generated from 5 items(comatose status, decision making, short-term memory, making self understood, and eating). Method: 393 patients in 2 hospitals for the elderly with dementia were measured with CPS by two nurses independently. The inter-rater agreement was tested by comparing two scores. The CPS score was compared with GDS, which was measured by doctors and nurses, and MMSE score which was drawn from the claim data of Health Insurance Review & Assessment Service. Result: The correlation coefficient between CPS and GDS was 0.742(p<0.0001), CPS and MMSE was -0.794(p<0.0001). The Cronbach's coefficient alpha of CPS was 0.742, Kappa value was 0.772~1.000. The CPS showed high validity and reliability in long term care hospitals of Korea.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.3-12
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• 1979

A survery was carried out in order to know the status of student health service and student medical insurance of universities and colleges in Korea from 1 July to 30 September. 1978. And the following results were obtained; 1. Out of seventy universities and colleges, 54.8% of them had student health service facility such as student health conte. (30.0%) or health room (24.8%). 2. Out of twenty-seven national and public universities and colleges, 44.4% of them had student health service facility and out of forty-three private universities and colleges, 60.5% of them had student health service facilities. 3. Each of 80.0% of 25 universities, 43.3% of 30 colleges and 33.3% of 15 junior colleges had student health service facility. 4. Major roles of student health service were physical examination (92.1%), health counselling (86.8%), primary medical care (78.9%), tuberculosis control (68.4%), insect and rodent control (52.6%), parasite control(47.4%), water source sanitation (44.7%), and dental health care (28.9%). 5. Out of 21 universities and colleges, 66.7% of them had full time doctor and 81.0% of them had full time nurse for student health center. And out of 17 universites and colleges, 5.9% of them had full time doctor and 33.3% of then had full time nurse for student health room. 6. The range of health fee was varied from 100 won to 1,400 won per student per semester and the average was 520 won. 7. Among 55 universities and colleges, 78.6% of them had carried out annual physical examination in 1977 and the rate of physical examination was 57.4%. 8. Out of 70 universities and colleges. 45.7% of them had tuberculosis control program and the prevalence rate was 6.0 per 1,000 students. 9. Student medical insurance program was developed by ten universities and one college among 25 universities and 45 colleges. 10. Student medical insurance benefit was varied according to university and college; the reduction rate of medical fee was 20% to 80% for not only in-patient but also out-patient. 11. The upper limit of pay claim was varied according to the university and college from 5,000 won to no-limitation for out-patient and from 30,000 won to no-limitation for in-patient. 12. The highest utility rate of student medical insurance program was found in university 'F' with the rate of 791 for out-patient and 12 for admitted patient per 1,000 students.

• Journal of the Korean Society of Safety
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• v.34 no.1
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• pp.115-121
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• 2019

Background: Due to the diversification and advancement of research, researchers have become to deal with a variety of chemical and biological harmful materials in the laboratories of universities and research institutes and the risk has increased as well. Therefore, it is necessary to strengthen the social safety net for laboratory accidents by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service, when the researchers become physically disabled by laboratory accidents. The purpose of this study is to secure researchers' health rights and to create a research environment where researchers can work with confidence by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service. Method: We analyzed the laboratory accidents by year, injury type, severity of accident and disability grade with the 6 year data from 2011 to 2016, provided by Laboratory Safety Insurance. Based on the analysis result, we predicted the financial impact on Laboratory Safety Insurance if we introduce a compensation annuity by disability grade which is similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service. Result :As of 2011, the insured number of Laboratory Safety Insurance was approximately 700,000. The Average premium per insured was KRW 3,339 and there were 158 claims. Total claim amount was KRW 130 million, whereas the premium was about KRW 2.3 billion. The loss ratio was very low at 5.75%. If we introduce a compensation annuity by disability grade similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service, the expected benefit amount for 1 case of disability grade 1 would be KRW 1.6 billion, assuming 2% of interest rate. Given current premium, the loss ratio, the ratio of premium income to claim payment, is expected 41.4% in 2017 and 151.6% in 2026. The increased loss ratio due to the introduce of the compensation annuity by disability grade is estimated to be 11.0% in 2017 and 40.4% in 2026. Conclusion: Currently, laboratories can purchase insurance companies' laboratory safety insurance that meets the standards prescribed by Act on the Establishment of Safe Laboratory Environment. However, if a compensation annuity is introduced, it would be difficult for insurance companies to operate the laboratory safety insurance due to financial losses from a large-scale accident. Therefore, it is desirable that one or designated entities operate laboratory safety insurance. We think that it is more desirable for laboratory safety insurance to be operated by a public entity rather than private entities.

• The Korean Society of Law and Medicine
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• v.24 no.2
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• pp.79-117
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• 2023

Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.

• Nutrition Research and Practice
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• v.5 no.4
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• pp.313-321
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• 2011

The Korea Food and Drug Administration (KFDA) revised the Health Functional Food Act in 2008 and extended the form of health functional foods to general food types. Therefore, this study was performed to investigate consumers' perceptions of the expanded form of health functional food and to predict consumption patterns. For this study, 1,006 male and female adults aged 19 years and older were selected nationwide by multi-stage stratified random sampling and were surveyed in 1:1 interviews. The questionnaire survey was conducted by Korea Gallup. The subjects consisted of 497 (49.4%) males and 509 (50.6%) females. About 57.9% of the subjects recognized the KFDA's permission procedures for health functional foods. Regarding the health functional foods that the subjects had consumed, red ginseng products were the highest (45.3%), followed by nutritional supplements (34.9%), ginseng products (27.9%), lactobacillus-containing products (21.0%), aloe products (20.3%), and Japanese apricot extract products (18.4%). Opinions on expanding the form of health functional foods to general food types scored 4.7 points on a 7-point scale, showing positive responses. In terms of the effects of medicine-type health functional foods versus generic health functional foods, the highest response was 'same effects if the same ingredients are contained' at a rate of 34.7%. For intake frequency by food type, the response of 'daily consistent intake' was 31.7% for capsules, tablets, and pills, and 21.7% for extracts. For general food types, 'daily consistent intake' was 44.5% for rice and 22.8% for beverages, which were higher rates than those for medicine types. From the above results, consumers had positive opinions of the expansion of health functional foods to generic forms but are not expected to maintain accurate intake frequencies or amounts. Thus, continuous promotion and education are needed for proper intake of generic health functional foods.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.105-116
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• 2021

Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.9
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• pp.386-394
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• 2017

The purpose of this study was to investigate how employed dental hygienists (graduates) and alumni are aware of dental health insurance and how to organize their classes for running efficient dental health insurance courses, and therefore to suggest opinions on the introduction of professional dental hygienist qualifications. The analyses was carried out using IBM SPSS Statistics 24.0. Sixty-nine students (56.1%) preferred one semester dental health insurance course as two semester courses and 63 students (51.2%) preferred theoretical course as practical course. Ninety-six (78%) students preferred dental health insurance claimants as others for their most necessary certification. Ninety-three dentists (75.6%) thought of the dental hygienist as the appropriate occupation for dental health insurance claims. The correlation coefficient was significant at the 0.01 level (both sides) and all showed a positive correlation. The effect of subjective understanding of dental health insurance and the perception of dental health insurance claim on students' intention to complete those courses explained 32% of the response, and the effect of the intention to complete those courses on the willingness to earn a certificate explained 22.3%. This study reveals the willingness of students to complete those courses to acquire qualifications in order to achieve a competitive advantage in employment, and suggests the necessity of institutional improvements such as changing the method of dental insurance education, varying the class time distribution, and introducing dental health insurance professional dental hygienist qualification in the country.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.