• Title/Summary/Keyword: Insurance rate

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Analysis of Changes in the Industrial Structure by the Ageing Rate in Korea (고령화율에 따른 농촌지역 산업구조 변화 분석)

  • Kwon, Younghyun J.;Kim, Euijune
    • Journal of Korean Society of Rural Planning
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    • v.20 no.4
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    • pp.183-192
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    • 2014
  • The purpose of this study is to examine the effect of regional ageing rate to industrial structures of rural areas in Korea. This paper shows that there are cause-effect relations between the industrial specialization and ageing rate in 'Agriculture', 'Finance & Insurance', and 'Real Estate & Leasing' sectors. The ageing levels are classified into ageing society, aged society, and super-aged society according to UN standard that cause different impacts on industrial specialization of regions. This paper finds that the industrial specialization is determined by the ageing levels. If there is an increase in ageing rate by 1% in ageing society, the industrial specialization of the three industries could be strengthened by 0.14%. But, ageing rates have negative impacts on the industrial specialization in aged society and super-aged society by 0.76% and by 1.20%, respectively, as increasing ageing rate by 1%. As the ageing rate progresses, 'Agriculture', 'Finance & Insurance' and 'Real Estate & Leasing'sectors have positive impacts on the industrial specialization in the ageing society. But 'Finance & Insurance' and 'Real Estate & Leasing' sectors have changed into negative impacts on the industrial specialization in the aged society. In the aged society, the employment of elderly persons of 'Agriculture' and 'Finance & Insurance' sectors increase by 1% makes positive impact on the industrial specialization by 1.54%, by 0.45%, respectively. The result of this paper can be applied to a significant guideline at establishing regional employment planning such as elderly customized employment, vocational training for rural areas, where above 14% of ageing rate.

Insurance risk analysis of kidney donors (신장 공여자의 보험의학적 위험분석)

  • Kim, Dong-Jin
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.18-21
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    • 2010
  • Background: The kidney transplantation is increasing. The kidney donation of a living donor is more common in Korea than in other countries. Underwriters may encounter a case of a kidney donor. So we need to determine medical risk for a living kidney donor. Methods: Comparative mortality figures were calculated from a source article using mortality analysis methods. Results: Mortality Ratio of a living kidney donor was estimated to 106%, and Excess Death Rate was 0.89 per 1000. Discussion: A healthy kidney donor is quite within standard, even better in terms of medical risk.

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A Study on Way to Classify Premium Rate Considering Flood Risk (홍수위험도를 고려한 보험요율 차등화 방안)

  • Sim, Gyu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2933-2939
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    • 2015
  • Premium rate should be applied the insurance objects are classified reasonably, depending on the degree of exposure to disaster risk. But the existing premium rate is applied same basic rate each cities and districts without the degree of exposure to disaster risk. In this study, we analyzed the exposure to flood risk using channel buffering and suggested way to classify the premium rate by reflecting the analysis results in order to improve its. It is determined that this study would contribute to calculate the storm and flood insurance basic rate reflected risk and make and analysis of flood risk of the local river that conditions of inundation simulation is insufficient.

Review of chronic obstructive pulmonary disease (COPD) in terms of insurance medicine (만성폐쇄성폐질환의 보험의학적 이해)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.29 no.1
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    • pp.12-15
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    • 2010
  • Global prevalence of chronic obstructive pulmonary disease(COPD) is known to 5.6 ~ 9.8%. Then life insurance applicants from persons with COPD are frequently encountered, and the underwriter and insurance medical doctors are called on with some regularity to render assessments of the mortality risk associated with COPD. According to previous article which contains long-term follow up of COPD, mortality ratio and excess death rate were 230% and 29 per 1000, respectively. Nowadays molecular genetic methodology such as GWAS has been developed. So it might be possible that molecular diagnostic methods may be one of useful underwriting tools in the life insurance risk selection of COPD applicants.

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Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county) (의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究))

  • Park, Jung-Yeon
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.47-76
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    • 1989
  • The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

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Impacts of DRG Payment System on Behavior of Medical Insurance Claimants (DRG 지불제도 도입에 따른 의료보험청구 행태 변화)

  • Kang, Gil-Won;Park, Hyoung-Keun;Kim, Chang-Yup;Kim, Yong-Ik;Ha, Beom-Man
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.393-401
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    • 2000
  • Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

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Policy Formulation of Health Insurance and Its Problems in Korea (의료보장정책의 형성과 문제점)

  • 이규식
    • Health Policy and Management
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    • v.10 no.1
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    • pp.57-94
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    • 2000
  • Korea's social health insurance system was introduced in 1977, which has made a universal coverage possibly by July 1989. Korean government had pursued a single objective for the last decade to put the whole population under the coverage of medical security, and the objective was achieved within 12 years. The rapid accomplishment is primarily due to such factors as limited benefits, high copayment rate, low contributions as well as rapid economic growth. There are several sources of pressure for the implementation of social health insurance such as health professional group, labor unions, politicians, international organizations etc.. However it is important to look at the feasibility of social health insurance. Among other things, it is necessary to identify the administrative infrastructure of insurance system and to assess income for source of fund. As many developed countries, Korea began to apply health insurance to the employees of the large firms, and the expansion based on employment status. Thus the several funds system was inevitable according to the gradual expansion strategy. However many persons had criticized several funds system in respect with equity and efficiency aspects. In the short history of the Korean health insurance, whether one fund or sever or funds had been the most controversial issue. In Febrary 1999, the National Assembly passed the act of one fund system. From July 2000 separate funds will be unifed under new health insurance scheme. In this study we will analyze the policy making process on implementation, expansion and integration of health insurance system of Korea. And also analyse problems related to policy making.

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A New Direction of National Pension System for Aging : Different age insurance premium rate and income replacement rate application (노령화로 인한 국민연금의 새로운 제도 방향: 연령별 차등 보험료율, 소득대체율 적용)

  • Park, Sanghong;Kim, Eunsoo;Park, Yiseul;Lee, Jiyun;Jun, Doobae
    • The Journal of the Convergence on Culture Technology
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    • v.4 no.4
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    • pp.201-206
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    • 2018
  • The fourth fiscal estimate of the national pension following the aging of the population and falling yields estimated that the fund ran out in 2057, three years earlier than the third fiscal calculation. Accordingly, the government proposed a plan to immediately raise the insurance premium rate by 2 percent and maintain the income replacement rate by 45 percent, and to reduce the income replacement rate by 40 percent in 2028. In this form, increasing premiums and reducing income replacement rates will allow younger generations to sign up differently from existing subscribers, who previously had higher income replacement rates at lower rates. Therefore, the study aims to ease the burden on the elderly and younger by applying different insurance rates and income replacement rates for different ages.

Analysis of Source of Increase in Medical Expenditure for Medical Insurance Demonstration Area before(1982-1987) and after(1988-1990) National Health Insurance (의료보험 시범지역의 전국민 의료보험실시전후의 진료비증가 기여도 분석)

  • Cha, Byeong-Jun;Park, Jae-Yong;Kam, Sin
    • Health Policy and Management
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    • v.2 no.2
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    • pp.221-237
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    • 1992
  • The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

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