• Title/Summary/Keyword: Korean Health Insurance Corporations

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Smoking prevention programs for young people in Korean health insurance corporations (건강보험공단 청소년 흡연예방교육의 현황과 문제점)

  • Sull, Jae-Woong;Yi, Sang-Wook;Sohn, Tae-Yong;Oh, Hee-Choul
    • Health Policy and Management
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    • v.12 no.4
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    • pp.56-67
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    • 2002
  • The objectives of this study were to look into the present conditions and problems of smoking prevention programs for young people carried out by the Korean health insurance corporation(KHIC) and to provide the basic data for the governmental policy. In order to examine the actual achievements of existing smoking cessation programs, a survey was conducted over 235 KHIC branches. The person responsible for the cessation program from each branch responded to questionnaire sent by mail with regard to smoking cessation programs The survey shows the shortage of responsible persons. educational subjects were mainly elementary, middle school and high school students. The main educational method was to watch the video of which the content is the knowledge of smoking. but most of these videos were made for adults. Therefore, these videos are not appropriate for the children. 37% of these branches estimated the effectiveness of their program. On the basis of the survey data and analysis of current situations, the following actions are recommended in order to develop a more effective cessation program; first, the establishment of the effective administrative plan, second, the supplementation of the educator and the responsible person, third, the development of text books and videos which are appropriate for the children.

The Responsibility of the State for Financing of the National Health Insurance (의료보험 재정에서의 국가 책임)

  • Lee, Jun-Young
    • Korean Journal of Social Welfare
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    • v.57 no.4
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    • pp.321-342
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    • 2005
  • The finance of the National Health Insurance(NHI) in nearly every Nation in the world has been traditionally based on premiums of the workers and employers. But in Korea, the government has been guaranteeing financial supports to regional health corporations. After the unification of the different corporations in the NHIC, the government will not have to give financial support to the NHIC. Then this will be a serious financial challenge to NHIC, which has usually had financial deficit. The purpose of this paper is to review the problems of the premium based financing of the NHI and to exam whether such problems will be solved through the financial support from the state to the NHI. The analysis in this paper focused on five viewpoints; 1) work relatedness 2) redistribution effect 3) financial burden of business firms through the premium 4) risk pooling 5) management hegemony of the NHI. As a result, it was found that there are many problems in every five aspects and these problems could be solve through the financial aid from the state. But, it does not without any restriction mean to suggest that the financing mode of the korean NHI should be wholly transformed to a tax based financing mode. Because there are many things to be considered in oder to alter the financing mode of the NHI. Nevertheless, this paper would give a logical background to enlarge the financial aid form the state to NHI, or at least, to maintain it at a present level.

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Factors affecting the price-reduction rates among the insurance medicines (의료보험약가 인하율에 영향을 미치는 요인)

  • Kim, Hyoung-Joong;Cho, Woo-Hyun;Kim, Han-Joong;Cheon, Byung-Yool
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.64-72
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    • 1992
  • To provide the information necessary for the insurance medicine management plan, price discount rates among the insurance medicines were studied. A total of 2,107 items of insurance medicine of which prices were discounted via governmental inspections of real transactional process of insurance medicine were analysed. The conclusions are as follows; 1. Among the variables relevant to the characteristics of manufacturers, price discount rates of insurance medicines were statistically significant with production rankings of manufacturers, incorporation year, existence of investments by foreign corporation, existence of a research institute, and enrollment in the exchange. And among the variables relevant to the properties of medicines, the number of enrolled items which have the same components, classification, the date of new enrollment, the sales of items, and the number of raw materials in the items were statistically significant. 2. Stepwise multiple regression was done to identify the factors which affect the price discount rates of insurance medicines. The number of enrolled items which have the same components, production rankings of manufactures, classification number (medicines for function of tissue cells), incorporation year(1940-1949), existence of investments by foreign corporations, classification number (anti-germ medicines), number of raw materials In the items, the sales of items, and medicines whose major objective is not treatment were significant variables and the $R^2$-value for these variables was 21.2%. Considering all of the above results, for management of insurance medicines, it seems important that the real transactional prices of insurance medicines should be identified systematically, focusing on the properties which affect the price discount rates of insurance medicines.

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Predictors of Quality of Life among Workers in Public Health Corporations (건강관련 공기업 사무직 근로자의 삶의 질 예측요인)

  • Eom, Hye-Jeang;Lee, Hae-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.2
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    • pp.153-161
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    • 2009
  • Purpose: The purpose of this study was to identify the predictors of Quality of Life (QOL) among workers in public health corporations. Methods: Data were composed of 213 office workers in three public enterprise in Seoul. Data were collected from February 11 to March 20, 2007. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression using SPSS Win 12.0 program. Results: The mean QOL of the study participants was 82.60. The QOLs of the workers were significantly different according to perceived health status of workers and working hours per week. The QOL of the workers was negatively related to working hours, job stress, and depression, and positively related to the health status, self-esteem, and health promotion lifestyle (HPLS). Significant predictors of QOL were HPLS ${\beta}=.420$), depression (${\beta}=-.291$), self-esteem (${\beta}=.261$), and hours of work per week (${\beta}=-.114$), which explained 63% in the variance of QOL. Conclusion: These results suggest that strategies to enhance HPLS could improve the level of QOL. Further investigations of the direct relationship between QOL and health promotion program is warranted.

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Maternal and Hospital Factors Impacting the Utilization of Rooming-in Care in South Korea: Secondary Analysis of National Health Data (모자동실이용에 영향을 미치는 산모와 의료기관 요인: 전국 자료를 이용한 2차 분석)

  • Kim, Yun-Mi;Kim, Eun-Young
    • Journal of Korean Academy of Nursing
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    • v.41 no.5
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    • pp.593-602
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    • 2011
  • Purpose: In this study analysis was done of utilization of rooming-in care in South Korean hospitals in order to examine the factors related to mothers and hospitals that affect rooming-in care. Methods: With the involvement of 254,414 mothers who gave birth across 953 hospitals, the analysis used the health insurance qualification data of the National Health Insurance Corporations and Health Insurance Review and Assessment Service (2006). Factors associated with rooming-in care were analyzed using a GEE logistic regression analysis to consider factors related to both mothers and hospitals. Results: Only 45.1% of the mothers used rooming-in care. The results of the regression analysis revealed that individual factors of the mothers were not associated with rooming-in care, whereas group factors of the hospitals were. Rooming-in care use was primarily related to small hospital, location of hospital, and higher nurse staffing level. Conclusion: The findings of this study indicate that the utilization of rooming-in care is not associated with factors an individual mother, but rather with the group factors of the hospitals. Thus, a policy-based approach considering both of these types of factors is required to enhance the utilization of rooming-in care.

A Study on the Type of Violations of Medical Law Regulations Which Restrict Opening a Medical (의료법상 의료기관 개설제한의 위반유형에 관한 연구)

  • Kim, Joon Rae
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.345-366
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    • 2014
  • Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.

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A Study on the Association between Healthcare Utilization and the Burden of Families Caring for the Elderly in the Last 6 Months of Life (노인의 사망 전 6개월간 의료이용수준과 간병가족의 가족부담과의 관련성)

  • Yi, Jee-Jeon;Lee, Hee-Na;Ohrr, Hee-Choul;Jung, Hye-Young;Yi, Sang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.332-338
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    • 2003
  • Objective : To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. Methods : The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. Results : 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age af death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. Conclusion : An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.

A Study of Cancer Cases by Industry in Kwangju-Chonnam Area - Based on Industrial Medical Insurance Record - (광주, 전남지역에서의 업종별 악성종양 발생에 관한 연구 - 1종 의료보험 자료를 중심으로 -)

  • Kim, Yong-Sik;Oh, Won-Moon;Park, Hyung-Cheol;Choi, Jin-Su;Song, In-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.2 s.30
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    • pp.207-215
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    • 1990
  • In order to investigate the occurrence characteristics of cancer in terms of industry in Kwangju-Chonnam area, medical utilization records of industrial medical insurance corporations during the period of 1987 to 1988 were reviewed for the identification of neoplastic disease. The cases obtained from the medical records were followed up for the verification and to get additional information. Standardized incidence data were compared by occupational characteristics. Multiple logistic regression analysis was applied to analyze the difference of incidence or distribution of cancer as a whole or of some selected cancer. Total cases of cancer identified were 242 during the study period. Annual incidence rate was calculated as 123.1 per 100,000 person. The frequent types of cancer were cancers of stomach, liver, lung, colon and rectum, bladder and lymphoma in descending order. Employees of mine and other sand handling industries showed significantly higher risks for cancer of stomach and cancer as a whole. Employees of the transportation industry showed the higher risk for cancer of liver, Workers in small-sized industry (${\leqq}100$) had a higher risk for cancer than who in large-sized industry (<100). These findings suggested the effect of occupational environmental exposure to cancer development.

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Development of a Linking Model between Community Resourses and Industrial Injury Insurance Organs for the Activation of Medical Rehabilitation Services for Industrial Injury Patients (산재환자의 의료재활서비스 활성화를 위한 산재보험시설과 민간시설간의 연계모형 개발)

  • Kim, Hee-Girl
    • Korean Journal of Occupational Health Nursing
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    • v.14 no.1
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    • pp.56-70
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    • 2005
  • Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.

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An Analysis of the Financial Performance of Korean Medicine Hospitals in Korea: Focusing on Financial Ratios and Investment Efficiency (재무분석을 통한 한방병원의 경영성과 분석 - 재무비율 및 투자효율을 중심으로)

  • Choi, WonYoung;Lim, Byungmook
    • The Journal of Korean Medicine
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    • v.41 no.1
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    • pp.1-10
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    • 2020
  • Objectives: This study investigated the financial performance of Korean Medicine hospitals in Korea in order to understand the current status of hospital management and improve its efficiency. Methods: Financial statements of 24 medical corporations, 19 juridical foundations and 18 school hospitals from 2016 to 2018 were obtained from the secondary data published by the Health Insurance Review and Assessment Service, the National Tax Service and the Korea Advancing Schools Foundation. Financial performance was measured on 6 dimensions: liquidity, profitability, activity, growth, cost and productivity (investment efficiency) by analyzing 8 financial indicators: Liability to Total Assets, Net Profit to Patient Service Revenues, Total Assets Turnover, Growth Rate of Patient Service Revenues, Operating Expenses to Patient Service Revenues, Value Added to Patient Service Revenues, Value Added to Total Assets, and Value Added to Personnel Expenses. Results: Korean Medicine hospitals showed lower Liability to Total Assets, Liquidity and Value Added to Total Assets than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than those of Western Medicine hospitals do. The net profit decreased significantly (-50.8%) in 2018 whereas Patient Service Revenues increased (6.9%) for the same period due to Operating Expenses increase and Non-Operating loss. Conclusions: These findings suggest that the Korean Medicine hospital sector in Korea needs to improve liquidity and financial structure and to enhance profitability by reducing Personnel Expenses and generating Non-operating revenues in order to improve its investment efficiency and competitiveness.