• Journal of Preventive Medicine and Public Health
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• 제30권2호
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• pp.428-436
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• 1997

Objectives : The purpose of this paper is to estimate the completeness of the Korean Medical Insurance Data in childhood asthma. Methods : Capture-recapture method was used to estimate the prevalence of childhood asthma and case ascertainment rate(completeness) of Korean Medical Insurance Data using two source model, 'Korean Medical Insurance Committee Data (KMICD)' and 'Nationwide Study of Asthma and Allergies in Korean Children'. The asthma cases were restricted to those who were born from 1981 to 1989 and were identified by their Resident Register Number. Asthma cases in Korean Medical Insurance Data were defined as cases coded by ICD-9 493 and ICD-10 J45. In 'Nationwide Study of Asthma and Allergies in Korean Children', asthma cases were defined as the children who had been diagnosed asthma and had experienced symptoms of asthma during the past 12 months. The defined cases in two data sources were matched by 13 digits Resident Register Number. The numbers of matched patients in two data sources were 245 of 32,825 eligible total subjects. Chapman and Wittes' nearly unbiased estimation was used for capture-recapture analysis of two data sources. Results : Observed prevalence rate of childhood asthma was 5.3% and estimated prevalence rate by capture-recapture analysis was 11.6%. The highest prevalence rate was observed in 6-7 age group and the older the rate decreased. The completeness (the proportion of cases ascertained by KMICD to the total observed cases by two data sources) was 20.6%, and ranged form 10.8% to 28.8% by area. Conclusions : Invalid diagnosis of cases might overestimate the prevalence of child-hood asthma and might underestimate the completeness of Korean Medical Insurance Committee Data in this study.

• Communications for Statistical Applications and Methods
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• 제24권3호
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• pp.211-226
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• 2017

The chain-ladder method, for which run-off data is employed is popularly used in the rate-adjustment and loss-reserving practices of non-life-insurance and health-insurance companies. The method is applicable when the underlying assumption of a consistent development pattern is in regards to a cumulative loss payment after the occurrence of an insurance event. In this study, a modified chain-ladder algorithm is proposed for when the assumption is considered to be only partially appropriate for the given run-off data. The concept of a structural-change point in the run-off data and its reflection in the estimation of unpaid loss amounts are discussed with numerical illustrations. Experience data from private health insurance coverage in Korea were analyzed based on the suggested method. The performance in estimation of loss reserve was also compared with traditional approaches. We present evidence in this paper that shows that a reflection of a structural-change point in the chain-ladder method can improve the risk management of the relevant insurance products. The suggested method is expected to be utilized easily in actuarial practice as the algorithm is straightforward.

• 보험의학회지
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• 제1권1호
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• pp.140-147
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• 1984

We've reviewed 5,067 cases of claims by death that had occured for about 5 years from January, 1979 to October, 1983. As a result, We came to following conclusions; First, the greater part of deaths above mentioned were due to the Disease of Adult such as the Malignant neoplasm(18.4%), a Heart disease(10.4%), Liver cirrhosis(9.1%) and the Cerebrovascular disease(7.6%) as well as Accidental Death(26.5%), which were occupied by 72% of the whole. Second, classifying them by medical examination or non-medical, deaths in case of non-medical examination showed 80.8% of the. whole. And for age, sections ranging from 40 to 49 and from 30 to 39 took the overwhelming portions by 36.9% and 29.8% respectively, both of which showed 66.7% of the whole. Third, for the period elapsed, deaths within 1 year from the entrance showed 21.3% and that from 1 years to under 2 years, 19.9%. Thus the rate of early death under 2 years stood for 41.2% of the whole. Fourth, for occupation of the insureds, commerce occupied 20.4%, company employees 14.4%, agriculture 13.3%. These three categories marked 48.8% of the whole. From this, it appeared that the accidental death rate of the insured with the risky occupation was much greater than orthers.

• 한국병원경영학회지
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• 제15권4호
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• pp.1-26
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• 2010

We achieved both industrialization and democratization during the shortest period in the world. We also achieved good performance in national health insurance: universal coverage, solidarity in financing, equitable access of health care. However, national health insurance system has faced the problem of sustainability: various expenditure and financing problems. The problem of sustainablity has two facets of economic sustainability and fiscal sustainability. Economic sustainability refers to growth in health spending as a proportion of gross domestic product(GDP). Rapid increasing rate of health spending exceeds the growth rate of domestic product. Growth in health spending is more likely to threaten other areas of economic activity. Concern on fiscal sustainability relates to revenue and expenditure on health care. Health care financing face demographic and technical obstacles. Democratic obstacle is aging problem. Technical obstacle is collection of contribution. Expenditure of health care has various problems in benefit structure and efficiency of health care system. In this article, I suggest several policy reforms to enhance sustainability: generating additional revenue from value added tax, changing method of levying contribution, increasing efficiency of health care system by introducing the competition principle. restructuring of benefit scheme of health insurance. contracting with health care institutions to provide health care services.

• 대기
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• 제34권2호
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• pp.107-121
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• 2024

In this study, we empirically analyzed the impact of physical risks due to climate change on the soundness and operational performance of the financial industry by combining economics and climatology. Particularly, unlike previous studies, we employed the Seasonal-Trend decomposition using LOESS (STL) method to extract trends of climate-related risk variables and economic-financial variables, conducting a two-stage empirical analysis. In the first stage estimation, we found that the delinquency rate and the Bank for International Settlement (BIS) ratio of commercial banks have significant negative effects on the damage caused by natural disasters, frequency of heavy rainfall, average temperature, and number of typhoons. On the other hand, for insurance companies, the damage from natural disasters, frequency of heavy rainfall, frequency of heavy snowfall, and annual average temperature have significant negative effects on return on assets (ROA) and the risk-based capital ratio (RBC). In the second stage estimation, based on the first stage results, we predicted the soundness and operational performance indicators of commercial banks and insurance companies until 2035. According to the forecast results, the delinquency rate of commercial banks is expected to increase steadily until 2035 under assumption that recent years' trend continues until 2035. It indicates that banks' managerial risk can be seriously worsened from climate change. Also the BIS ratio is expected to decrease which also indicates weakening safety buffer against climate risks over time. Additionally, the ROA of insurance companies is expected to decrease, followed by an increase in the RBC, and then a subsequent decrease.

• 보건행정학회지
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• 제19권4호
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• pp.53-65
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• 2009

Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

• 보험의학회지
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• 제26권
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• pp.31-39
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• 2007

Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.

• 통상정보연구
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• 제10권1호
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• pp.259-277
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• 2008

This paper empirically analyzes the influence of export insurance on export promotion using panel data for the Korean case during the sample period from 2003 to 2006. We use the Korean export's share in trading partners' imports as a weight for the weighted least square (WLS) estimation to measure the effect of export insurance on the export promotion. Our main finding is that export insurance subsidy seems to enhance the export performance when the Korean export takes greater share in other countries' markets. On the other hand, under weaker monopoly power of the Korean export, export risk and trading partners' GDP growth rate has more influence on the export promotion rather than export insurance subsidy. Our finding implies that policy makers and practitioners should discern the Korean exports' monopoly power differential across trading countries for better performing export insuarnce policy.

• 경영과정보연구
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• 제3권
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• pp.77-97
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• 1999

The purpose of this paper is to measure the international competitiveness of insurance business and to analyze its determinants empirically. I have attempted to use Revealed Comparative Advantage(RCA) index to measure domestic competitiveness. confining to OECD countries only. Among domestic competitiveness advantage countries in the insurance, there are Austria, Denmark, France. Japan, Korea... etc. The factors of domestic competitiveness determinants were found out through multivariate regression analysis with panel data$(1990{\sim}1995)$. In insurance industry, statistically significant variables are employee's per capita premium of insurance company (Pro), stock market capitalization/GDP(MVESR), saving rate (SAV) and real interest(RMMR), while they are Pro, MVESR, and real interest in Korea insurance industry.

• 대한예방한의학회지
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• 제1권1호
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• pp.137-148
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• 1997

The Serial Securities and the Social Welfare, as the national policy aimed at securing generals' lives, are the policies or systems for the stabilization in lift; especially of law-incomers and workers, for which the povernment has to establish the Social Security System. No wonder the Social Insurance System is a part of the Social Security System and the most important. The Social Insurance System, along with Public Assistance, is underlying the Social Security System. Social Security System includes medical insurance, industrial accident Compensation insurance, national pention insurance and employment insurance. The study is on 'The Oriental Medical Insurance and the Industrial Accident Compensation in the Social Security System' . The rate of industrial accident in Korea marks the highest rank in the world. for laborer, industrial accident do not merely mean the loss of health but the question of the right to live in terms of their loss of opportunity of life. The industrial accident compensation system should be established as the es post facto remedy system to guarantee the injured worker and his/her family's life. The oriental medical insurance system which began to operate in 1987 in Korea is based on unionism and divided into 3 parts; one part for the worker, a second part for the community inhabitants, and a third part for the public service personnel and private school personnel. Today the medical problem must be the most important social assignment to be considered. The medical system of contemporary industrial society has began greatly stood out in relief as a part of social welfare not emphasized on gainings of physicians. Accordingly systematization of the oriental medical insurance was strongly Pursued and it was developed to to the extent of entire nation insurance. Though the history of it is very short, most of the people are getting benefit from the insurance system by the social security system method. This study develops the Oriental Medical Insurance, the Workmen's Accident Compensation Insurance, the Pension System in relation to the industrial accident compensation of Employees, along with the ideas and principles of social insurance.