• 제목/요약/키워드: Insurance rate

검색결과 999건 처리시간 0.027초

풍수해보험요율 산정을 위한 전국단위 내수침수해석 방안 (Nationwide Inundation Analysis method for Flood and Storm Disaster Insurance Rate)

  • Yoo, Jaehwan;Song, Juil;Jang, Moonyup;Kim, Hantae
    • 한국재난정보학회 논문집
    • /
    • 제11권1호
    • /
    • pp.55-62
    • /
    • 2015
  • 본 연구에서는 풍수해보험요율 산정을 위한 전국단위의 내수침수해석 방안을 제시하였다. 제시된 수정 Level-Pool침수해석은 실제 침수피해지역을 반영하고 내수침수 발생 범위를 한정하기 위해 도시계획 용도지역을 고려하였다. 수정 Level-Pool침수해석에 의한 내수침수지역과 풍수해저감종합계획의 내수재해위험지구와 비교를 통해 적용성을 검토한 결과 기존 Level-Pool침수해석과 비교하여 내수침수지역이 내수재해위험지구를 더 정확하게 재현하는 것으로 나타났다. 따라서 전국단위의 내수침수위험지역을 해석함에 있어서는 본 연구에서 제안한 수정 Level-Pool침수해석이 활용 가능할 것으로 판단된다.

급성호흡기감염 환자의 표시과목별 항생제 처방특성 -국민건강보험 빅데이터를 활용하여- (Prescription Characteristics of Antibiotics for Clinical Subjects of Acute Respiratory Infection Outpatients -Using National Health Insurance Big Data-)

  • 공미진;황병덕
    • 보건의료산업학회지
    • /
    • 제13권4호
    • /
    • pp.121-132
    • /
    • 2019
  • Objectives: This study analyzed the prescription antibiotics characteristics of Acute respiratory infection outpatients. It provides a basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods: The research data were collected from the National Health Insurance Corporation's 2014 sample cohort for Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics classification of diseases codes J00-J06, J20-J22, J40 outpatients. Results: The antibiotic prescription rate on the evaluation project for appropriate prescribing indicators of Health Insurance Review & Assessment Service was 43.54%, whereas in this study it was about 10% higher because the analysis targeted the entire acute respiratory infection diagnosis. Conclusions: There is a need to identify the correct antibiotic prescription by expanding the current assessment standard. Such standard must include acute lower respiratory infections and minor diagnosis because current evaluation projects on appropriate prescribing indicators targets only the major diagnosis of acute upper respiratory infection.

타이어 제조회사에서의 참여적 근골격계질환 예방관리프로그램 적용효과 (The Effectiveness of Participatory Ergonomics Programs for Prevention of Musculoskeletal Disorders in the Tire Manufacturing Company)

  • 이윤근;한인임
    • 한국산업보건학회지
    • /
    • 제19권1호
    • /
    • pp.51-63
    • /
    • 2009
  • In the field of ergonomics, it is evident that participatory action research methodology could contribute to reduce risk factors of work related musculoskeletal disorders(WMSDs). The objective of this study was to evaluate the effectiveness of a participatory ergonomics in reducing the incidence rate and severity of WMSDs in the tire manufacturing company. In this study, an action committee comprising 13 members was organized in the tire manufacturing company. The action group participated at every research process, education and training, assessment and intervention of risk factors, and early detection and management of WMSDs during the 3 years(2004-2006). The prevention programs contributed to an overall reduction in incidence rate by approximately 37.2%, and lost workdays and workers' compensation costs by approximately 55.1%. But, the incidence rate increased 29.0%, and compensation costs increased 59.0% in the first-year setting programs, and both the incidence rate and compensation costs decreased after the second-year managing programs. And, the reduction rates(63.2%) of insurance cases is higher than that(9.7%) of non-insurance cases. The results showed that participatory ergonomics programs may be effective in reducing the incidence and severity rate of WMSDs.

Patterns of the Diagnosis Prevalence of Psychiatric Disorders in the Population Aged 0-18 Years Based on the Nationwide Insurance Sample Data

  • Lee, Seung Yup;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제31권4호
    • /
    • pp.214-224
    • /
    • 2020
  • Objectives: This study aimed to examine the trend in diagnostic prevalence of psychiatric disorders in children and adolescents. Methods: Individuals aged 0-18 years were included in the study based on the National Health Insurance Claims Data. To investigate the trends in diagnosis and diagnostic prevalence of psychiatric disorders reflecting the decrease in the birth rate, data were analyzed from 2010 as a reference year to 2015. Results: The number of patients diagnosed with psychiatric disorder decreased annually, from 23,412 on 2010 to 18,821 on 2015. The most common disorder was hyperkinetic disorder in male and depressive episode in female. Although there was no significant change in overall diagnostic prevalence rate of psychiatric disorders, age groups <10 years and some disorders had significant changes in prevalence rate. This study classified the diagnostic prevalence by age into two unique patterns: group in which the diagnosis rate increases with age and group in which the diagnosis rate peaks at a certain age and then decreases. Conclusion: Diagnostic prevalence of psychiatric disorders was different according to age and sex. These patterns should be reflected in the formulation of policies related to mental health and in medical practice for pediatric patients. It is urgent to identify how these patterns change in young adults.

델파이기법을 이용한 급성심근경색증 질 평가지표 가중치 부여 (Weighting of Acute Myocardial Infarction Quality Indicators using Delphi Method)

  • 김형선;조연희
    • 한국보건간호학회지
    • /
    • 제28권3호
    • /
    • pp.565-573
    • /
    • 2014
  • Purpose: Health Insurance Review & Assessment Service (HIRA) launched an Acute Myocardial Infarction(AMI) assessment for the Payment For Performance(Quality Incentives) Pilot Project from July 2007. Assessment measures of AMI were composed of five process measures and one outcome measure, and each measure was incorporated into one composite quality score to Pay for Performance. Method: For calculation of composite quality score, we considered weighting for the measures using the Delphi method. The questionnaire was composed of three measure groups, 'Reperfusion rate'(Fibrolytic therapy received within 60 minutes of hospital arrival, Primary Percutaneous Coronary Intervention within 120 minutes of hospital arrival), 'Medication prescription rate'(Aspirin at arrival, Aspirin prescribed at discharge, Beta-blocker prescribed at discharge) and 'Survival Index'(30-day mortality rate). Result: A panel composed of 18 and completed a questionnaire by allocation of 10 scores to the three above mentioned measure groups. The Delphi was carried out until three rounds of surveys. In conclusion, each measure group was weighted differently and the 10 scores were allocated as 4.5 to 'Reperfusion rate', 2.5 to 'Medication prescription rate', and 3.0 to 'Survival Index'. Conclusion: The results of this study proposed the calculation method for weighting of Acute Myocardial Infarction quality indicators.

한국의 구직급여 수급률 결정요인 분석 (Unemployment Insurance Take-up Rates in Korea)

  • 이대창
    • 노동경제논집
    • /
    • 제39권1호
    • /
    • pp.1-31
    • /
    • 2016
  • 고용노동부 "고용보험DB" 의 상실자 종합통계와 실업급여 지급통계를 이용하여 구직급여 수급자격자의 수급과 재취업에 따른 수급자격 상실을 경합적 위험(competing risks)모형으로 분석하였다. 아울러 구직급여 수급률과 경기지수 간의 교차상관관계 분석을 하였다. 분석결과 구직급여 수급률이 실업률과 정(+)의 상관관계를 보이고, 6개월가량 실업률과 경기동행지수를 선행한다. 아울러 수급률이 연령, 학력, 급여지급기간, 소득대체율과 정(+)의 상관관계를 보이고 있다.

  • PDF

건강보험 빅데이터를 통한 전체 근로자 및 공무원 근로자의 암 발생률 분석 (Analyzing Cancer Incidence among Korean Workers and Public Officials Using Big Data from National Health Insurance Service)

  • 백성욱;이완형;유기봉;이우리;이원태;김민석;임성실;김지현;최준혁;이경은;윤진하
    • 한국산업보건학회지
    • /
    • 제32권3호
    • /
    • pp.268-278
    • /
    • 2022
  • Objectives: This study aimed to establish a control group based on the big data from National Health Insurance Service. We also presented presented the number of incidences for each cancer, and analyzed the cancer incidence rate among Korean workers. Methods: The cohort definition was separated by 'baseline cohort', 'dynamic cohort', and 'fixed- industry cohort' according to the definition. Cancer incidence was calculated based on the Korean Standard Classification of Disease code. Incidence rate was calculated among the group of all workers and public officials. Based on the study subjects and each cohort definition, the number of observations, incidences, and the incidence rate according to sex and age groups was calculated. The incidence rate was estimated based on the incidence per 100,000 person-year, and 95% confidence intervals calculated according to the Poisson distribution. Results: The result shows that the number of cancer cases in the all-worker group decreases after the age of 55, but the incidence rate tends to increase, which is attributed to the retirement of workers over 55 years old. Despite the specific characteristics of the workers, the trend and figures of cancer incidence revealed in this study are similar to those reported in previous studies of the overall South Korean population. When comparing the incidence rates of all workers and the control group of public officials, the incidence rate of public officials is generally observed to be higher in the age group under the age of 55. On the other hand, for workers aged 60 or older, the incidence rates were 1,065.4 per 100,000 person-year for all workers and 1,023.7 per 100,000 person-year for civil servants. Conclusions: This study analyzed through health insurance data including all workers in Korea, and analyzed the incidence of cancer of workers by sex and age. In addition, further in-depth researches are needed to determine the incidence of cancer by industry.

Supraeruption as a consideration for implant restoration

  • Lee, Bo-Ah;Kim, Byoungheon;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
    • /
    • 제50권4호
    • /
    • pp.260-267
    • /
    • 2020
  • Purpose: The aim of this study was to compare the prevalence, amount, and rate of supraeruption of the maxillary second molar according to sex, age, and history of periodontitis. Methods: Data were collected retrospectively from the charts and panoramic radiographs of 65 patients who were scheduled to undergo implant placement at the site of the mandibular second molar. The amount of supraeruption of the maxillary second molar and the alveolar bone level of the neighboring teeth were measured on digital panoramic radiographs. The prevalence was evaluated in each group, and univariate and multivariate logistic regression analyses were used to identify factors influencing the prevalence of supraeruption. The amount and the rate of supraeruption were compared between pairs of groups using the Mann-Whitney U test. For all tests, P values <0.05 were considered to indicate statistical significance. Results: Supraeruption occurred in 78% of the patients. The prevalence of supraeruption was affected by sex, age, and history of periodontitis. The mean amount of supraeruption was 0.91 mm and the mean rate of supraeruption was 0.14 mm/month. The amount and the rate of supraeruption showed no significant differences according to sex, age, or the distance from the cementoenamel junction to the alveolar bone crest (P>0.05). Conclusions: These results show that the amount of supraeruption on the maxillary second molar was similar to the thickness of the enamel on the occlusal surface. When a single implant is scheduled to be placed on the mandibular second molar, supraeruption of the antagonist should be considered.

원격진료 보수지불체계 설정방향에 관한 연구 (Development of a Payment System for Telemedicine)

  • 염용권;명희봉;이윤태;김동욱;서원식;이관익
    • 보건행정학회지
    • /
    • 제7권2호
    • /
    • pp.65-88
    • /
    • 1997
  • In Korea, telemedicine is still under the beginning stage, but we expect that the developing 'Information Highway' will make this technology more common place and more easily used in coming soon. Currently, three hospitals are providing telemedicine services with their subsidiary hospitals which are far away from their remote place. However, the fee schedule of telemedicine services are not well-settled down, of course not reimbursed through current health insurance system. This study aims to develop new payment system for medical services provided through telemedicaine system. To design appropriate fee schedule for telemedicine services, we, first, review the current insurance payment system and telemedicine system both in domestic and foreign countries focusing on its payment system. A framework of telemedicine payment system is proposed in following steps based on information we acquired from this stage. Second. We decide the span of cost items which should be covered by telemedicine payment scheme. In hear, we suggest payment method for telemedicine services should be designed as dual structure which are telemedicine fee that should be reimbursed through payment scheme and any costs related to capital investment that should not be covered by payment system. Which is, payment system for telemedicine services should cover only service-related costs and any costs related to capital investment should be generated through third party such as government, health insurance association, etc. Finally, we suggest new fee schedules for telemedicine services. The key issues on developing telemedicine fee schedules are related with the determination of appropriate additional rate($\alpha$). The reasonable additional rate($\alpha$) must determine through careful evaluation of any additional efforts(e. g. : additional work hours which are related to providing telemedicine services). This study shows the process of how to determine appropriate additional rate($\alpha$).

  • PDF

건강보험 청구자료를 이용한 일반 질 지표로서의 위험도 표준화 재입원율 산출: 방법론적 탐색과 시사점 (Developing a Hospital-Wide All-Cause Risk-Standardized Readmission Measure Using Administrative Claims Data in Korea: Methodological Explorations and Implications)

  • 김명화;김홍수;황수희
    • 보건행정학회지
    • /
    • 제25권3호
    • /
    • pp.197-206
    • /
    • 2015
  • Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.