• 한국사회정책
• /
• v.23 no.1
• /
• pp.203-225
• /
• 2016

The permanent disability benefit(PDB) system whose purpose lies in helping affected workers with their self-realization through compensating them for their work-related injury or disease and facilitating their timely return to work is very important in terms of social welfare. Actually, the portions of PDB's in all WCI expenditures have been on the sharp increase. In spite of its positive aspects like this, however, an excessive amount of PDB's may have negative impacts on the affected workers' will to work or return to work, and increasing trends in the amount of PDB's payable in annuity will remain in an aging or aged society a potentially risky factor posing a threat to the soundness of WCI budgets. In this respect, the author attempted herein to identify the long-term reality of trends in the number of claimants entitled to PDB's and the amount of PDB's payable to them through making the long-term budget projections of PDB's; address problems with PDB's payable in annuity, which are or will potentially be one of the gravest burdens in securing the soundness of WCI budgets; and discuss how to optimize the amount of PDB's through studying & analyzing overseas cases and income replacement rates and what kinds of improvements are thinkable. It's recommended to reduce the absolute amount of benefits payable in annuity in a phased way considering claimants' life-cycle instead of sticking to the current system, which takes the form of lifelong pension plan.

• Health Policy and Management
• /
• v.29 no.2
• /
• pp.206-219
• /
• 2019

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.18
• /
• pp.8541-8551
• /
• 2016

Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

• Health Policy and Management
• /
• v.24 no.3
• /
• pp.228-241
• /
• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• Health Policy and Management
• /
• v.23 no.3
• /
• pp.289-300
• /
• 2013

Background: Patients' trust in their physicians or hospitals is important to guarantee the effectiveness of care and to encourage revisits. This study aimed to identify the relationship between the experience of requesting verification of healthcare benefit coverage via the Health Insurance Review Agency (HIRA) and patients' trust in their physicians or hospitals. Methods: For this population-based study, 800 adult respondents aged 20 to 65 years were recruited using random sampling and telephone surveys. Respondents were divided into two groups: 1) 400 people had experience in requesting the HIRA verification service for the purpose of confirmation of whether the costs they paid were appropriate among metropolitan habitants, and 2) 400 people comprised members of the public who had no experience requesting the verification service. Results: Experience with requesting verification services was likely to lower the patients' trust in medical institutions, but not in their physicians (p<0.05). In addition, patients who were satisfied with their physicians and hospitals were more likely to trust the physicians and hospitals than dissatisfied patients. Conclusion: Patients' trust might be an important factor influencing hospital success. Patients' trust in medical suppliers, such as physicians and hospitals, encourages a positive relationship between medical suppliers and patients. Therefore, medical suppliers must provide appropriate care to patients to improve patients' trust in them.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
• /
• v.77
• /
• pp.113-144
• /
• 2018

This study explores how to prevent the fraudulent export financing and its subsequent export insurance fraud in relation to O/A negotiation. Under the traditional letter of credit(L/C) transactions, the banks, as a negotiation bank, can extend trade financing to the exporters through negotiation of draft and/or shipping documents. Under the O/A transaction scheme, however, bank cannot ascertain existence of trade performance and it is much riskier to extend an advance financing to the exporters before the buyer sends confirmation of debt. In O/A negotiation. some exporters tried to fraud banks by falsifying the shipping documents and the size and gravity of this fraudulent export financing were huge. Therefore, this study examines the banking process in O/A-based trade financing, documents examination process, the negotiation of instruments, treatment of trade financing in export credit guarantee, most importantly, explores what could be the criteria for appropriate treatment of account receivable to insure the safe transfer of account receivable. To maximize the benefit for optimum trade financing, the Bank of Korea established several Trade Finance Rules (refers to "BOK Rules") requiring that commercial banks should maintain optimal credit limits(so called, 'the principle of optimal loan') to extend the trade finance. The K-sure post-shipment credit guarantee programs and short-term export insurance program(EFF)can also facilitate 'the principle of optimal loan' principle.

• The Korean Journal of Applied Statistics
• /
• v.21 no.4
• /
• pp.639-647
• /
• 2008

This study used the characteristics of the knowledge discovery and data mining algorithms to develop tailored hypertension follow up management model - hypertension care predictive model and hypertension care compliance segmentation model - for hypertension management using the Korea National Health Insurance Corporation database(the insureds’ screening and health care benefit data). This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques on hypertension care predictive model and hypertension care compliance segmentation model was developed by Decision tree analysis. This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation’s building of a Hypertension follow up Management System in the near future by bringing forth representative results on the rise and care of hypertension.

• Korean Journal of Health Education and Promotion
• /
• v.23 no.4
• /
• pp.13-28
• /
• 2006

Objectives: This study used the characteristics of the knowledge discovery and data mining algorithms to develop hypertension predictive model for hypertension management using the Korea National Health Insurance Corporation database(the insureds' screening and health care benefit data). Methods: This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques. Results: Major results of logistic regression analysis suggested that the probability of hypertension was: - lower for the female(compared with the male)(OR=0.834) - higher for the persons whose ages were 60 or above(compared with below 40)(OR=4.628) - higher for obese persons(compared with normal persons)(OR= 2.103) - higher for the persons with high level of glucose(compared with normal persons)(OR=1.086) - higher for the persons who had family history of hypertension(compared with the persons who had not)(OR=1.512) - higher for the persons who periodically drank alcohol(compared with the persons who did not)$(OR=1.037{\sim}1.291)$ Conclusions: This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation's building of a Hypertension Management System in the near future by bringing forth representative results on the rise and care of hypertension.

• Journal of Korean Medicine Rehabilitation
• /
• v.27 no.2
• /
• pp.67-75
• /
• 2017

Objectives The study of the clinical effects of traditional east asian medicine (TEAM) using Taiwan national health insurance claim dataset (NHIRD) is useful in Korean Medicine research. We reviewed the clinical studies of TEAM using NHIRD as a whole through this study. Methods We comprehensively searched PUBMED and NHIRD DB for clinical effects of TEAM study using NHIRD from inception to 17, January 2017. As a result, 40 studies investigating the contribution of TEAM intervention to health benefit have been confirmed. We analyzed publication time, target disease, sample size, outcome measurement and main result of 40 searched studies. Results The number of TEAM studies using NHIRD grdually increasing. The topics of the team study using NHIRD covered a wide range of subjects including cardiovascular disease, tumor, gynecological disease, diabetes and kidney disease. The studies have shown large samples and reported significant effects on severe diseases. Conclusions The results of this study suggest that the study of Korean Medicine using Big data will be useful for decision making related to health care in Korea. However, considering the limited domestic Korean health insurance data, it will be necessary to activate the big data research of Korean Medicine through the establishment of a separate cohort in Korea.

• Korean Journal of Health Education and Promotion
• /
• v.31 no.2
• /
• pp.41-53
• /
• 2014

Objectives: The purpose of this study was to evaluate the education contents on safe use of medications in healthcare textbooks for elementary, middle and high schools. Methods: We examined 6 textbooks for the $5^{th}$ grade, 4 textbooks for middle school, 3 textbooks for high school, and 5 education materials published by the Korea Food and Drug Administration, National Health Insurance Service, and Seoul City Government. To evaluate the contents in health textbooks, we developed the 30 evaluation items. Results: Middle school textbooks had the most educational contents followed by high school and elementary school textbooks. Public education materials for the teenagers included more educational contents than those for children. The education material published by National Health Insurance Service had the highest score and the rest of the books earned under 15. And there were no core contents in medication education. Conclusions: Medication education through health textbooks should be strengthened to raise the level of medication awareness, to use medications safely, to prevent the drug abuse and misuse, and to establish the responsible judgment of medication information in the mass media. The current contents were found to be insufficient to meet these goals of medication education.