• Title/Summary/Keyword: Medical Benefit

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Problems of National Medical Expenses Management in Korea (한국 국민의료비 관리의 문제점 분석 : 건강보험, 산재보험, 자동차보험을 중심으로)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.263-272
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    • 2011
  • The purpose of this study is suggesting proper management methods for the national health expenditures by considering advanced countries and analysing the problems of national health expenditures management in korea. The majors results of the research are as follows. First, most advanced countries is integrating the management of national health expenditures about health insurance, workmen's accident compensation insurance and auto insurance etc, and medical prices and benefit standards are same regardless of insurance type. Second, national health expenditures has been managing separately by national health systems in korea, and there are many problems like the differences medical expenditure review and payment, medical prices and benefit standards etc. Although same symptoms and disease, there is great difference in health service utilization. Hereafter, management system of national health expenditures must be integrated, and must change same medical prices and benefit standards.

Regional Difference of Chronic Periodontal Care Services in Korea (의료기관 종별 만성 치주염 진료의 지역 간 차이)

  • Yoon, Young-Ju;Lee, Kyeong-Soo;Kim, Chang-Suk;Kim, Chang-Yoon;Hwang, Tae-Yoon
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.5
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    • pp.899-905
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    • 2015
  • Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

The Recognition of Groups between the Korean National Health Insurance and the Private Health Insurance (국민건강보험과 민영의료보험에 대한 집단 간의 인식도 분석)

  • Im, Bock-Hee;Lim, Jeong-Do
    • The Korean Journal of Health Service Management
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    • v.5 no.2
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    • pp.157-172
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    • 2011
  • The purpose of this study is to provide basic information for improving medical security between the Korean National Health Insurance Corporation and the private health insurance in Pusan Metropolitan area by investigating of the recognition with the benefit groups. Questionnaires of 431 were taken between Feb. 11th and Feb. 25th 2008. The survey was carried out to gather information about SES and contents of insurance and recognition between the benefit group of the Korean National Health Insurance and the private health insurance on the financial conditions and the stability. The result of survey is as follows. First, there is a difference between the National Health Insurance and the private health insurance on the financial conditions and the stability of the Korean National Health Insurance. Second, there is a high score at the private health insurance on the financial conditions and the stability of the private health insurance. Third, privatizing of a National Health Insurance is high score at increase of the premium, medical payments of the National Health Insurance group and is high score at enhance of quality of medical service and decrease of loss of medical payment of the private health insurance group. Therefore, to provides more information and improved medical security with the benefit group. it is necessary for concerns to put more efforts in creating Conflicting vs. Complementing of systemic base.

The Effects of Changed Selective Treatment System on Medical Service Usage and Payments for Lung Cancer Patients (선택진료제도 개선이 폐암환자 의료이용 및 본인부담액에 미치는 영향)

  • Jeon, Insook;Lee, Haejong
    • Korea Journal of Hospital Management
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    • v.22 no.4
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    • pp.61-73
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    • 2017
  • In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

A Cost Benefit Analysis of Individual Home Visiting Health Care (맞춤형 방문건강관리사업의 비용-편익분석)

  • Kim, Jin-Hyun;Lee, Tae-Jin;Lee, Jin-Hee;Shin, Sang-Jin;Lee, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.21 no.3
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    • pp.362-373
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    • 2010
  • Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

Effects of the benefit extension policy on the burdening of health care expenditure for households with patients of chronic or serious case (보장성 강화정책이 만성질환자 및 중증질환자 보유가구의 과부담 의료비 발생에 미친 영향)

  • Choi, Jung-Kyu;Jeong, Hyoung-Sun;Shin, Jeong-Woo;Yeo, Ji-Young
    • Health Policy and Management
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    • v.21 no.2
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    • pp.159-178
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    • 2011
  • Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in 'out-of-pocket expenditure as a share of the ability to pay' and 'incidence rate of catastrophic health care expenditure' of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare Panel Study (KoWePS), conducted by the Korea Institute for Health and Social Affairs (KIHASA), were used for the analysis, where low-income households and ordinary households are sampled separately. While the absolute amount of 'out-of-pocket expenditure' occurred to the average household increased for the period 2005-2007, the 'out-of-pocket expenditure as a share of the ability to pay' decreased. At the same time, the share decreased in the case of low-income households and households with patients of chronic or serious case as contrasted with ordinary households. 'Incidence rates of catastrophic health care expenditure' of ordinary households for 2007 stood at 14.6%, 5.9% and 2.8% at the threshold of 10%, 20% and 30%, respectively. The rates decreased overall between 2005 and 2007, while those of low-income households with patients of serious case statistically significantly increased. An analysis of this study indicates that it is related with the medical bill ceiling system regardless of incomes introduced in 2007.

Predictive Significance of VEGF and HIF-1α Expression in Patients with Metastatic Colorectal Cancer Receiving Chemotherapy Combinations with Bevacizumab

  • Berk, Veli;Deniz, Kemal;Bozkurt, Oktay;Ozaslan, Ersin;Karaca, Halit;Inanc, Mevlude;Duran, Ayse Ocak;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6149-6154
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    • 2015
  • Background: There is no suggested molecular indicator for the determination of which patients will benefit from anti-angiogenetic treatment in metastatic colorectal cancers. Materials and Methods: In this study, VEGF and $HIF-1{\alpha}$ expression and their clinical significance were studied in tumor tissues of patients with colorectal cancer receiving bevacizumab-based treatment. VEGF and $HIF-1{\alpha}$ were assessed by immunohistochemistry in the primary tumors of 53 metastatic colorectal cancer patients receiving chemotherapy in combination with first line bevacizumab. Results: The clinical benefit rate in the low-VEGF expression group was 38%, while it was 62% in the high expression group. While the median progression-free survival (PFS) was 10 months in the high-VEGF expression group, it was 8 months in the low-VEGF expression group (p = 0.009). The median overall survival (OS) was found to be 26 months vs 15 months. Thus, when VEGF was strongly expressed it was in favor of that group and the difference was statistically significant (p = 0.03). High VEGF expression rate was an independent factor that correlated with OS or PFS (p=0.016 and 0.009, respectively). Conclusions: The data showed that VEGF may have predictive value for determining the treatment of CRC.

Effect of Private Health Insurance on Medical Care Utilization: Six Year Unbalanced Panel Data Model (민간의료보험 가입 유형별 의료 이용: 6개년 불균형패널 분석)

  • You, Chang-Hoon;Kang, Sung-Wook;Choi, Ji-Heon;Kwon, Young-Dae
    • The Korean Journal of Health Service Management
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    • v.11 no.3
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    • pp.51-64
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    • 2017
  • Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

For Non-for-Profit medical institutions, tax exemption benefits such as the United States should be basically provided. (비영리법인 의료기관의 과세 제도를 정비해야 할 시점: 미국 수준의 면세혜택 제공을 검토해야)

  • Lee, Jin Yong;Kim, Hyun Joo;Eun, Sang Jun
    • Korea Journal of Hospital Management
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    • v.23 no.4
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    • pp.81-86
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    • 2018
  • Purposes: The purpose of this study is to argue that the taxation system for non-for-profit medical institution in Korea should be revised and that the basic direction should be to expand tax exemption like the US. Methods: We analyzed the US context of taxation policy for non-for-profit medical institutions and compared the US and Korean situation. Findings: In the United States, for-profit or non-for-profit medical institutions eternities are the most important criteria for hospital classification. Basically, full tax-exemption has been applied for non-for-profit medical institutions. The reason why many hospitals maintain their status as non-for-profit are following. First, the American society places great importance on the social responsibility and role of non-for-profit hospitals. Second, maintaining the status of non-for profit medical institutions is financially beneficial while maintaining good social reputation. The most powerful financial incentives are tax deductions and tax deductions for donations. Practical Implications: How will the taxation system for medical institutions in Korea be reformed in the future? First, if Korean government do not allow for-profit medical institutions, Korean government should consider implementing a full tax exemption system suitable for non-profit medical institutions like the US. Second, there are many variation in taxation for non-for-profit medical institution according to their legal positions. Therefore, current taxation system should be revised. Third, the reorganization of such taxation system should be in a direction that can finally encourage community benefit activities of medical institutions of nonprofit hospitals.

Radiation risk perception and its associated factors among residents living near nuclear power plants: A nationwide survey in Korea

  • Sung, Hyoju;Kim, Jung Un;Lee, Dalnim;Jin, Young Woo;Jo, Hyemi;Jun, Jae Kwan;Park, Sunhoo;Seo, Songwon
    • Nuclear Engineering and Technology
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    • v.54 no.4
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    • pp.1295-1300
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    • 2022
  • There has been increased interest in researching risk perception of radiation to implement successful risk communication, particularly given the recent worldwide nuclear policy movement regarding nuclear energy. This study aimed to investigate characteristics of risk perception among residents living near normally operating nuclear power plants in South Korea by identifying factors associated with risk perception. A survey was conducted with face-to-face interviews for 1200 residents aged 20e84 years by gender- and age-stratified random sampling. Risk perception was associated with trust perception in nuclear safety, but was not highly correlated with benefit perception for utilizing nuclear power. Relatively high risk perception was observed in women, older age groups, and residents not having experience of nuclear-related education or work. This association remained after adjusting for other factors including benefit perception, trust perception, and psychological distress. In addition to these individual characteristics, risk perception was also associated with a residential district's own unique context, indicating that a strategy of risk communication should be developed differently for residents facing nuclear-related circumstances. Given that risk perception can be changed, depending on social values such as safety culture and economic setting, further studies are required to understand the changing characteristics of radiation risk perception.