• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.147-157
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• 2011

Purpose: This study was done to investigate factors affecting perceived financial burden of medical expenditures. Method: The participants were 2,024 inpatients who were enrolled in a survey on the benefit coverage rate of the National Health Insurance in 2006. The collected data were analyzed using t-test, ANOVA-test, Mann-Whitney-test, Kruskal-Wallis-test, Chi-square test and logistic regression. Results: The crucial factors for perceived financial burden were age, job, equivalence scale, ratio of annual family income vs medical expenditure, and private health insurance. Perceived financial burden was higher for people who were older, who were unemployed, whose medical expenditures were high compared to annual family income, whose index of family equalization was low and for those who had no private health insurance. Conclusion: The results of the study indicate a demand for system reform that will enable management of no-pay hospital bills in the National Health Insurance to decrease the medical expense of people in the low-income bracket.

• Safety and Health at Work
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• v.2 no.2
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• pp.148-157
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• 2011

Objectives: Although compensation for occupational injuries and diseases is guaranteed in almost all nations, countries vary greatly with respect to how they organize workers' compensation systems. In this paper, we focus on three aspects of workers' compensation insurance in Organization for Economic Cooperation and Development (OECD) countries - types of systems, employers' funding mechanisms, and coverage for injured workers - and their impacts on the actual frequencies of occupational injuries and diseases. Methods: We estimated a panel data fixed effect model with cross-country OECD and International Labor Organization data. We controlled for country fixed effects, relevant aggregate variables, and dummy variables representing the occupational accidents data source. Results: First, the use of a private insurance system is found to lower the occupational accidents. Second, the use of risk-based pricing for the payment of employer raises the occupational injuries and diseases. Finally, the wider the coverage of injured workers is, the less frequent the workplace accidents are. Conclusion: Private insurance system, fixed flat rate employers' funding mechanism, and higher coverage of compensation scheme are significantly and positively correlated with lower level of occupational accidents compared with the public insurance system, risk-based funding system, and lower coverage of compensation scheme.

• Journal of East-West Nursing Research
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• v.25 no.2
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• pp.157-165
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• 2019

Purpose: This study aims to provide basic data for the development of measures and promoting home health nursing by examining the current status and trends in home health nursing for long-term care (LTC) insurance beneficiaries. Methods: Secondary data, including annual LTC insurance statistics reports for 2010-2017 and LTC manpower data, were used to compute current status and trends in the provision of home health nursing. Results: Beneficiaries of home health nursing under LTC insurance, insurance-covered costs for home health nursing, home health nursing provider, and home health nursing providing institution only accounted for 3% of all insurance-covered home care services, and were on a consistent decline since 2010. In particular, vulnerable rural regions with high proportion of individuals had poor infrastructure in terms of home health nursing institutions and manpower, but had a higher home health nursing utilization rate compared to urban regions. Conclusion: In addition to measures to support home health nursing service beneficiaries, policy measures are needed to support home health nursing service personnel and institutions. Furthermore, programs to cultivate the expertise of home health nurses and improve quality of home health nursing services should be developed in order to promote home health nursing utilization in vulnerable rural regions.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

• Korean Business Review
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• v.19 no.1
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• pp.25-34
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• 2006

This research executed research that analyze construction cost and profitability through construction example of direction and subcontracting construction based on common private construction less than 3 billion. The results of this research, is summarized as follows. (1) Analyzed profitability about construction gross and operating profit of direction and subcontracting construction. The construction gross profit rate is 15.2% direction construction, subcontracting construction was analyzed by 1.3% high by 16.5% subcontracting construction, and the operating profit rate is 9.4% direction construction, subcontracting construction was construed by 2.3% high by 11.7% subcontracting construction. (2) Analyzed profitability about operating profit before and after deduction of 4 insurance cost of direction construction. The direction construction operating profit rate is 9.4% before deduction of 4 insurance cost, after deduction was construed that is 7.3% and operating profit rate difference after and before deduction was construed that is 2.1%. Therefore, subcontracting construction (operating profit rate 11.7%) was analyzed that last operating profitability after 4 insurance cost deduction produces more 4.4% about direction construction.

• Journal of the Korean Data and Information Science Society
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• v.24 no.4
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• pp.723-736
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• 2013

The importance of lapse rate is highly increasing due to the introduction of Cash Flow Pricing system, non-refund-of-reserve insurance policy, and IFRS (International Financial Reporting System) to the Korean insurance market. Researches on lapse rate have mainly focused on simple data analysis and regression analysis, etc. However, lapse rate can be analyzed by survival analysis and can be well explained in terms of several covariates with Cox proportional hazard model. Guaranteed minimum benefits embedded in variable annuities require more elegant statistical analysis of lapse rate. Hence, this paper analyzes data of policyholders with variable annuities by using Cox proportional hazard model. The key variables of policy holder that influences the lapse rate are payment method, premium, lapse insured to term insured, reserve-GMXB ratio, and age.

• Journal of Gastric Cancer
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• v.13 no.4
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• pp.247-254
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• 2013

Purpose: In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy. Materials and Methods: A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method. Results: The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001). Conclusions: The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.20-27
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• 2016

Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.37-44
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• 1985

A study on the occurrence of hepatitis B has been done for 2,680 employees in Daehan Life Insurance Company. The positive rates of HBsAg and anti-HBs were 6.56% and 18.9% respectively. The positive rates of HBsAg and anti-HBs were higher by 2.25% and 2.06% respectively in male than in female. HBsAg and anti-HBs positives were higher at age of 30 to 50 years than other age groups. The drinker group shows higher positive of HBsAg and anti-HBs by 10.44% and 4.26% respectively than non-drinker group. Most of the results of liver function tests in HBsAg positive cases were within reference ranges. HBsAg or anti-HBs positive rate in the family members of HBsAg or anti-HBs positive employees was higher than the over-all positive rates of all subjects, by 14.55% in case of HBsAg and by 2.21% in case of Anti-HBs.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.71-74
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• 2003

Liposarcoma is one of the most common malignancies originating from human soft tissue. Because most of liposarcoma occur in the lower extremities or retroperitoneum, there are few reports about liposarcoma of head and neck region, including larynx and pharynx. Histologically, there are four types of liposarcoma, and prognosis and recurrence rate are different according to histologic subtype. Wide excision is the treatment of choice and liposarcoma hardly respond to primary radiotherapy. A 56-year-old man presented with voice change and foreign body sensation in laryngopharynx. Hypopharyngeal liposarcoma was diagnosed by surgical biopsy and performed totallaryngopharyngoesophagectomy and gastric pull-up. Here we report our experience on this case with review of literature.