• 제목/요약/키워드: National Health Insurance

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Health Insurance Benefit Criteria and Quality Assurance Policies of Diagnostic Ultrasound Services in Other Countries (주요국의 초음파검사 시행현황과 질 확보방안)

  • Chung, Seol Hee;Lee, Hye Jin;Kim, Han Sang;Oh, Ju-Yeon
    • Health Policy and Management
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    • v.24 no.2
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    • pp.109-119
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    • 2014
  • In accordance with the government's plan to expand the national health insurance (NHI) coverage for severe diseases such as cancer, heart disease, cerebrovascular disease, and rare and incurable disease, the diagnostic ultrasound services have been covered by NHI from October 1, 2013. The quality is very important factor in providing diagnostic services because they influence on the diagnosis, treatment, and outcome of diseases. In particular, equipments and health care providers plays an important role in providing qualitative services. The purpose of this paper is to examine the major feature of ultrasound services covered by health security system and to review quality assurance policies in other countries such as Australia, Japan, the USA, and Canada. In addition, we assessed the implication of those policies. We especially put emphasis on the types and qualifications of healthcare professionals and measures to manage equipments. All countries have reviewed on policies to promote the quality such as educational requirements of professionals or restrictions on the duration of equipment usage. Various measures should be implemented to assure the qualitative ultrasound service.

The study of Beauty industry parts' current social insurance status and its analysis (미용업 분야의 사회보험 가입 실태 및 분석에 관한 연구 -헤어, 네일, 피부, 메이크업 분야를 중심으로-)

  • Choi, Seo-Yeon;Lee, Hyun-Jin
    • Journal of the Korea Safety Management & Science
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    • v.15 no.4
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    • pp.393-399
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    • 2013
  • The purposes of this study were to seek beauty industry parts' current social insurance admission status. To achieve the purposes, questionnaire was distributed to a total of 470 beauty artists and data were analyzed by statistical analysis. The result of study proposed that hairdresser showed the highest awareness and field of nail art showed the lowest awareness in social insurance admission status. Social insurance admission status shows that beauty artists in hair field had the most applicants of national pension, health insurance, workers' compensation insurance and beauty artists of skin field had the highest desire for social insurance application. This study hopes to be used as base line data of social insurance applicants' accurate status and application.

Factors related to Family Caregiver Satisfaction with the Institutional care services under the Public Long-Term Care Insurance system (노인장기요양보험 시설서비스에 대한 가족수발자 만족도 영향 요인)

  • Kwon, Jin-Hee;Han, Eun-Jeong;Lee, Jung-Suk
    • Health Policy and Management
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    • v.19 no.4
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    • pp.78-97
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    • 2009
  • This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

The Relationship between Home-Visit Nursing Services and Health Care Utilization among Nursing Service Recommended Beneficiaries of the Public Long-Term Care Insurance (노인장기요양보험 방문간호 권고군의 방문간호 이용과 의료 이용의 관계)

  • Kang, Sae Bom;Kim, Hongsoo
    • Health Policy and Management
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    • v.24 no.3
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    • pp.283-290
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    • 2014
  • Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

An Analysis of Factors Affecting Medical Operating Income at Regional Public Hospital (지방의료원 의료이익에 대한 영향요인 분석)

  • Jin Won Noh;Jeong Hoe Kim;Hui Won Jeon;Jeong Ha Kim;Hyo Jung Bang;Hae Jong Lee
    • Health Policy and Management
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    • v.33 no.1
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    • pp.55-64
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    • 2023
  • Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.

Treatment of Brachymetatarsia by Distraction Osteogenesis (중족골 단축증의 신연 골형성술 치료)

  • Oh, Hyun-Chul;Lee, Yun-Tae;Ha, Joong-Won;Park, Yung;Choi, Yun-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.42-46
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    • 2005
  • Purpose: To evaluate the efficacy of distraction osteogenesis for fourth brachymetatarsia. Materials and Methods: Seven patients (10 cases) who were treated by distraction osteogenesis for fourth brachymetatarsia from March 2000 to December 2003 were reviewed retrospectively. Results: The average length gain of fourth metatarsus was 16.6 mm (37%) and the average healing index was 50 days/cm. The final results according to AOFAS functional scale were excellent in 8 cases and good in 2 cases. Conclusion: Distraction osteogenesis is an effective treatment for fourth brachymetatarsia in spite of some minor complications.

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Dental hygienist's recognition of national health insurance coverage of toothbrushing instruction (칫솔질 교육 건강보험 급여화에 대한 치과위생사의 인식)

  • Gkuk, Jung-Suk;Lee, Jae-Ra
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.4
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    • pp.751-758
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    • 2012
  • Objectives : This study aimed to seek the national health insurance coverage and the efficient direction of toothbrushing instruction and to contribute to establishing policy as auxiliary data, targeting 373 dental hygienists who are working in some areas of Jeonnam. Methods : A research method was questionnaire survey by individually self-administration method. Results : It was indicated to agree to the national health insurance coverage of toothbrushing instruction in the better understanding and cooperation level with toothbrushing instruction, in case of carrying out toothbrushing instruction, and in the higher age group. Conclusions : There will be a need of allowing the national health insurance coverage to be formed in the direction at which the dental service providers and the dental service consumers can be satisfied, by being performed a comprehensive and sufficient research for this.

A Study of Whether Extinctive Prescription and Joint Payment Apply to the Right of Imposing Fine on the Law of National Health Insurance or Not ("국민건강보험법" 상 과징금부과처분 권한에 대한 소멸시효 적용여부 및 과징금 연대 납부 의무 유무)

  • Park, Tae-Shin
    • The Korean Society of Law and Medicine
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    • v.12 no.2
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    • pp.189-217
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    • 2011
  • According to the current law of national health insurance, the Minister of Health and Welfare can impose a suspension of business or license, and a fine with medical institutions who violate the law. In case that medical institutions raise an action for ity with each penalty, they ask for replacing the suspension of business with a fine during the pendency of the action. But there is a long gap of time between an offense and administrative measures. One violation cause several types of administrative measures (suspension of business or fine, suspension of license etc.) and different government departments impose these penalties. It takes a lot of time to organize their opinions and they are liable to impose penalties after considerable space of time because of overwhelming tasks. Then the medical institutions can sustain a loss by getting unexpected administrative measures after their offense against the law. Thus, this article review whether extinctive prescription apply to the right of imposing fine on the law of national health insurance or not. Meanwhile, we have no regulations imposing a same fine to co-representatives of medical institution who infringe the law of national health insurance. On this point, this study review whether they have equal duty on that or not.

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