• Title/Summary/Keyword: Insurance Service

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Anterior tympanic plate fracture following extraction of the lower molar

  • Kim, Yeon-Ho;Kim, Moon-Key;Kang, Sang-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.51-54
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    • 2016
  • The present case report describes an external auditory canal injury following extraction of the lower molar. The external auditory canal was torn in the same fashion that occurs in an anterior tympanic plate fracture. This case demonstrates one of the rare complications associated with dental extractions.

The Income and Cost Estimate for the Medical Clinic Services Based on Available Secondary Data (이차자료원을 활용한 의원 의료서비스 수입 및 비용 산출)

  • Kim, Sun Jea;Lim, Min Kyoung
    • Korea Journal of Hospital Management
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    • v.26 no.1
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    • pp.71-82
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    • 2021
  • Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

The Effect of Long-Term Care Ratings and Benefit Utilization Characteristics on Healthcare Use (노인장기요양 등급 및 급여 특성이 의료이용에 미치는 영향)

  • Kang Ju Son;Seung-Jin Oh;Jong-Min Yoon
    • Health Policy and Management
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    • v.33 no.3
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    • pp.295-310
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    • 2023
  • Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

Determinant Factors in Cost to Feed for Long-Term Care Facilities Residents (장기요양 시설서비스 식사재료비 크기 결정요인 분석)

  • Kwon, Jinhee;Han, Eun-Jeong;Jang, Hyemin;Lee, Hee Seung
    • Health Policy and Management
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    • v.29 no.2
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    • pp.195-205
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    • 2019
  • Background: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. Methods: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. Results: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). Conclusion: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.

Observations on Long-Term Care Insurance Utilization and Implication for its Expansion (노인장기요양보험 이용현황과 제도확대방향의 모색)

  • Yun, Hee-Suk
    • Health Policy and Management
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    • v.20 no.3
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    • pp.104-122
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    • 2010
  • Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

A Case of Symmetrical Lipomatosis Limited of the Tongue (혀에 국한하여 발생한 대칭성 지방종증 1예)

  • Jeong, Se Won;Nam, Jae Sung;Kie, Jeong Hae;Shin, Hyang Ae
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.58-62
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    • 2015
  • Benign symmetric lipomatosis, also known as Madelung's disease, Launois-Bensaude syndrome and multiple symmetric lipomatosis is a cutaneous condition characterized by extensive symmetric fat deposits in the neck, shoulders, and upper trunk. But symmetrical lipomatosis of the tongue is very rare and characterized by involvement exclusively of the tongue, invasiveness, and absence of encapsulation of the adipose tissue. A 75-year-old man presented with about a year history of painless tongue masses on both lateral border. Bilateral partial glossectomy was performed and subsequently was confirmed as symmetrical lipomatosis pathologically. We report this case with a review of the literatures.

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Primary extracranial meningioma presenting as a forehead mass

  • Kim, Chae Min;Jeon, Yeo Reum;Kim, Yee Jeong;Chung, Seum
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.55-59
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    • 2018
  • Meningioma originates from arachnoid cap cells and is the second most common intracranial tumor; however, it can also be found in an extracranial location. A very rare primary extracranial meningioma without the presence of an intracranial component has also been reported. Primary extracranial meningiomas have been found in the skin, scalp, middle ear, and nasal cavity. A computerized tomography or magnetic resonance imaging scan is necessary to determine the presence or absence of an intracranial meningioma, and a biopsy is essential for diagnosis. We report a case of primary extracranial meningioma located in the forehead skin of a 51-year-old male.

Intraparotid Facial Nerve Schwannoma

  • Cho, Hyung Rok;Kwon, Soon Sung;Chung, Seum;Choi, Yoon Jung
    • Archives of Craniofacial Surgery
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    • v.15 no.1
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    • pp.28-31
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    • 2014
  • Intraparotid facial nerve schwannoma is a rare benign neoplasm. Due to its rarity, it is not usually a prioritized diagnosis before surgery and may therefore lead to an unintentional treatment error. In this article, we report a single case of intraparotid facial nerve schwannoma. We were able to make a diagnosis with frozen biopsy. A complete resection of the mass while preserving the facial nerve was performed. Herein we present our clinical experience with regards to the treatment process of intraparotid facial nerve schwannoma.

A Case of Angiokeratoma Circumscriptum of the Dorsal Tongue (설배부에 발생한 국한성 혈관각화종 1예)

  • Nam, Jae Sung;Hong, Chang Eui;Kim, Yee Jeong;Shin, Hyang Ae
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.47-50
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    • 2016
  • Angiokeratomas represent vascular lesions and are histologically characterized by superficial dermal vascular ectasia with overlying epidermal hyperkeratosis. Angiokeratoma circumscriptum is one of five types in the group of the angiokeratomas. The lesion is present from birth but may appear in childhood or adulthood. Angiokeratoma circumscriptum is typically hyperkeratotic papules or nodules situated unilaterally on the foot or distal aspect of the leg, but can occur elsewhere on the body. Isolated tongue involvement is very rare. We report a 12-year-old boy with angiokeratoma circumscriptum of the posterior dorsal tongue with a review of the literatures.

A Case of Myxoid Liposarcoma of Neck (경부에 발생한 점액성 지방육종 1예)

  • Lee, Kyuin;Kie, Jeong Hae;Shin, Hyang-Ae;Kim, Ji-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.71-75
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    • 2021
  • Liposarcoma is a very rare malignant tumor affecting the head and neck area. Since it is an invasive and life-threatening disease, active treatments is necessary. However, differential it from lipoma, its corresponding benign counterpart, may be difficult. Herein, we report a rare case of posterior neck myxoid liposarcoma in a 72-year-old man who was initially misdiagnosed with lipoma, including a literature review of differential diagnosis between lipoma and liposarcoma.