• Title/Summary/Keyword: Insurance beneficiary

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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.

Factors Related to Family Caregivers' Burden with the Community-Dwelling Disabled Elderly under the Long-Term Care Insurance System (장기요양 재가서비스 이용자를 돌보는 가족주부양자의 부양부담감에 영향을 미치는 요인)

  • Han, Eun-Jeong;Lee, Jung-Myun;Kwon, Jin-Hee;Shin, Seul-Bi;Lee, Jung-Suk
    • Health Policy and Management
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    • v.24 no.1
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    • pp.71-84
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    • 2014
  • Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

A Study of Hospital Foodservice Management after Covering Hospital Foodservice in The National Health Insurance (식대 급여화에 따른 입원 환자 병원 급식 실태 조사)

  • Hwang, Rah-Il;Kwon, Jin-Hee;Jeong, Hyun-Jin;Kim, Jung-Hee;Lee, Ho-Young
    • Korean Journal of Community Nutrition
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    • v.13 no.2
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    • pp.244-252
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    • 2008
  • The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, $x^2$-test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.

Knowledge, attitude, and recognition of health insurance coverage in tooth implant (임플란트에 대한 지식 및 태도와 건강보험 급여화 인식)

  • Kim, Hyun-Jung;Lee, Sun-Mi;Ahn, Se-Youn;Kim, Chang-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.195-204
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    • 2016
  • Objectives: The purpose of the study is to investigate the knowledge, attitude, and recognition of health insurance coverage in tooth implant among Korean adults. Methods: A self-reported questionnaire was completed by 420 adults over 20 years lod in Seoul and Gyeonggido from October 1 to December 15, 2014. The questionnaire consisted of general characteristics of the subjects, knowledge, attitude, and recognition of health insurance coverage in tooth implant. Results: The mean of knowledge of regular checkup after implant was 3.05 points, and mean of advantage and disadvantage of implant was 3.03 points. The expectation for the implant treatment was 4.18 points and this was the highest score. There was no significant difference between the knowledge and attitude in age and monthly compensation(p>0.05). Only 45.6% of the adults were aware of the health insurance coverage of tooth implant since July, 2014. Health Insurance meeds to be modified in the beneficiaries age(44.6%), and cost(32.7%). The positive aspects of implant care included medical expenses(37.8%), health care beneficiary(29.1%), and oral health promotion(20.9%). Conclusions: Health insurance coverage of tooth implant is very important to enhance the quality of life in the adults because the proper management and implementation of the health insurance in implant will improve the oral health care in life.

A Comparative Analysis of Smoking-Associated Factors in Wonju-si and Chuncheon-si: Based on the National Health Insurance Service-Health Screening Database (원주시와 춘천시 흡연 관련 요인 비교 분석: 국민건강보험공단 건강검진 DB 바탕으로)

  • Yun-Ji Jeong;Lee-Seo Seol;Hyung-Kyung Cho;Hyun-Ji Lee;Kwang-Soo Lee
    • Korea Journal of Hospital Management
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    • v.28 no.1
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    • pp.24-36
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    • 2023
  • Purposes: The purpose of this study was to analyze the factors associated with current smoking status in Wonju-si and Chuncheon-si, and to study the cause of difference in smoking rates between these two regions. Methodology: Data was from the National Health Insurance Service database from 2019 to 2020. Current smoking status was based on the response to the health examination questionnaire. Logistic regression analysis was conducted to identify factors associated with current smoking status. The study included 207,307 individuals from Wonju-si and 173,698 individuals from Chuncheon-si. Findings: The smoking rate of Wonju-si was 19.83%, and Chuncheon-si was 18.20%, showing a difference in the smoking rates between the two regions. Logistic regression analysis found that men, those aged 40-49, being a self-employed insured, a medical-aid beneficiary, having a lower income, working in construction, transport, storage, communication, or manufacturing industries, having a high-risk drinking level and being underweight were significantly associated with a higher likelihood of smoking(p<0.05). Additionally, having a chronic disease was associated with a lower likelihood of smoking in the case of Chuncheon-si(p<0.05). Practical Implication: This study found the differences of factors associated with smoking rates between the two regions and could provide implications for establishing intervention programs or policies that could contribute to lowering the smoking rate in areas with high smoking rates.

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Utilization Rate of Medical Facility and Its Related Factors in Taegu (대구시민의 의료기관 이용률과 연관요인)

  • Kim, Seok-Beom;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.29-44
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    • 1989
  • A household survey was conducted to determine the utilization rate of medical facilities and to identify the factors related with the utilization in the South District of Taegu from July 3 to July 15, 1988. Study population included 1,723 family members of 431 households which were selected by one-stage simple cluster random sampling. Well trained medical college students interviewed mainly housewives with a structurized questionnaire. Morbidity rate of acute illness during the 2-week period was 101 per 1,000 persons and it was highest in the age group of 9 years below. The rate for chronic illness was 77 per 1,000 persons, increasing with age, low income and medicaid benefit. During the 2-week period, 689 of 1,000 persons utilized the medical facilities. Of the facilities, most number, 294, used hospital and clinic, and the order ran as pharmacy, health center, and herb medical clinic. The utilization rate was higher in the female, 70-year and older group, medicaid group, the lowest income class and self-employed group than other groups. The average number of visits among users of medical facilities during the 2-week period was 3.25. those who visited medical facilities most frequently were females, the 70-year and older group, the lowest income class and blue collar worker group. During one-year period, admission rate of 1,000 persons was 27.6 and that of female was 38.9, higher than that of male. the eldest group had the highest admission rate. Admission rate of medical insurance beneficiaries was twice or higher than non-beneficiaries. The higher the family monthly income, the more frequently they admitted. During one-year period, average admission days of the persons hospitalized were 22.5 days and males were hospitalized longer than females. The groups which were hospitalized longest were those between the ages of 40 and 49, medical insurance beneficiaries, the lowest income group and unemployed group. During one-year period, average admission days of 1,000 persons were 560 days and those of female were 661 days, more than those of male. The guoups which had the longest admission days were those above 70 years of age, the lowest income and unemployed groups. The medical insurance beneficiaries were three times or longer than non-beneficiaries. In logistic regression analysis of utilization of physician significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), acute illness episode(+), chronic illness episode(+), medical insurance beneficiary(+) and white collar workers(-). Acute and chronic illness episode(+), and medical insurance for government employees and private school teacher(-) were significant variables in analysis of utilization of pharmacy. In multiple regression analysis of the number of physician visits, siginificant variables were acute illnes episode(+), chronic illness episode(+), industrial, occupational and regional medical insurance beneficiary(+), white collar workers(-). Acute and chronic illness episode(+), and medical insurance beneficiary(-) were significant variables in analysis of the number of pharmacy visits. In logistic regression analysis of admission event, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+) , chronic illness episode(+), and medical insurance beneficiary(+).

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The Relief Effect of Copayment Decreasing Policy on Unmet Needs in Targeted Diseases (산정특례제도가 미충족 의료경험에 미치는 영향: 2·4차 한국의료패널자료를 이용하여)

  • Choi, Jae-Woo;Kim, Jae-Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.24 no.1
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    • pp.24-34
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    • 2014
  • Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

A Study on the Guarantee Instruments and Types in the International Business Contracts (국제(國際) 비즈니스 계약(契約)에서의 보증수단(保證手段) 및 유형(類型)에 관한 연구(硏究))

  • Park, Suk-Jae
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.26
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    • pp.203-223
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    • 2005
  • Many international transactions involve the use of security devices, commonly referred to as "guarantees", "bonds", or "standby credits", designed to protect one of the parties from a breach by its counter-party. These security mechanisms may be provided by banks, insurance companies, specialized surety companies, or other financial service firms. Although some legal systems distinguish between "guarantees", "bonds", and "indemnities", these terms are often used as synonyms in the everyday language of international traders. It may therefore be necessary to examine the particular characteristics and nature of the guarantee obligation in order to properly classify the guarantee. Two main categories of guarantee are demand and suretyship. Under a demand guarantee, the guarantor must pay on first demand by the beneficiary. The beneficiary only has to demand payment under the guarantee - there is no need to prove that the principal has actually defaulted on a contractual obligation. Under a suretyship or conditional guarantee, the obligation of the guarantor is triggered by the actual default or contractual breach of the principal, as evidenced in a document such as a court judgement or arbitral award against the principal. Guarantees have been widely used in the international business transactions. Main uses of guarantees are as follows : Performance Bonds/Guarantees, Bid(or Tender) Bonds/Guarantees, Advance Payment or Repayment Bonds/Guarantees, Retention Bonds/Guarantees, Maintenance(or Warranty) Bonds/Guarantees etc.

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A Study on the Unfair Calling under the Independent Guarantee (독립보증상의 수익자에 의한 부당청구(unfair calling)에 관한 연구)

  • Oh, Won-Suk;Son, Myoung-Ok
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.42
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    • pp.133-160
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    • 2009
  • In International trade the buyer and seller are normally separated from on another not only by distance but also by differences in language and culture. It is rarely possible for the performance of obligations to be simultaneous and the performance of contracts therefore calls for trust in a situation in which the parties are unlikely to feel able to trust each other unless they have a longstanding and successful relationship. Thus the seller under an international contract of sale will not wish to surrender documents of title to goods to the buyer until he has at least an assurance of payment, and no buyer will wish to pay for goods until he has received them. A gap of distrust thus exists which is often bridged by the undertaking of an intermediary known and trusted by both parties who will undertake on his own liability to pay the seller the contract price in return for the documents of title and then pass the documents to the buyer in return for the reimbursement. This is a common explanation of the theory behind the documentary letter of credit in which the undertaking of a bank of international repute serves as a "guarantee" to each party that the other will perform his obligations. The independence principle, also referred to as the "autonomy principle", is at the core of letter of credit or bank guarantee law. This principle provides that the letter of credit or bank guarantee is independent of the underlying contractual commitment - that is, the transaction that the credit is intented to secure - between the applicant and the beneficiary ; the credit is also independent of the relationship between the bank and its customer, the applicant. The most important exception to the independence principle is the doctrine of fraud in the transaction. A strict interpretation of the rule that the guarantee is independent of the underlying transaction would lead to the conclusion that neither fraud nor manifest abuse of rights by the beneficiary would constitute an objection to payment. There is one major problem related to "Independent guarantees", namely abusive or unfair callings. The beneficiary may make an unfair calling under the guarantee. The countermeasure of beneficiary's unfair calling divided three cases. First, advance countermeasure namely by contract. In other words, when the formation of the contract, the parties must insert the Force Majeure Clause, Arbitration Clause to Contract, and clear statement to the condition for demand calling. Second, post countermeasure namely by court. Many countries, including the United States, authorize the courts to grant an order enjoining the issuer from paying or enjoining the beneficiary from receiving payment under the guaranty letter. Third, Export Insurance. For example, the Export Credit Guarantees Department is prepared, subject to certain conditions, to cover the risk of unfair calling. Of course, KEIC in Korea is cover the risk of the all things for guarantees. On international projects, contractor performance is usually guaranteed by either a standby letters of credit or Independent guarantee. These instruments will be care the parties.

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A Determining System for the Category of Need in Long-Term Care Insurance System using Decision Tree Model (의사결정나무기법을 이용한 노인장기요양보험 등급결정모형 개발)

  • Han, Eun-Jeong;Kwak, Min-Jeong;Kan, Im-Oak
    • The Korean Journal of Applied Statistics
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    • v.24 no.1
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    • pp.145-159
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    • 2011
  • National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.