• Journal of Preventive Medicine and Public Health
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• 제39권6호
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• pp.511-519
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• 2006

Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

• 보건행정학회지
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• 제22권3호
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• 대한치과의사협회지
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• 제54권6호
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• pp.457-467
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• 2016

The National Health Insurance Service(NHIS) has been selectively covering the elderly on the dental implant and removable denture treatment and gradually expanding the eligibility criteria. Every dentist needs to have a good understanding of the insurance policy to provide qualified dental service to the beneficiaries and to avoid confusions and complications. In order to help dentists understand the NHIS requirements, the definitions, categories, and procedures of dental implant and conventional denture treatment are suggested.

• 보건행정학회지
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• 제31권4호
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• pp.423-436
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• 2021

This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

• 보건행정학회지
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• 제19권3호
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• pp.109-124
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• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.203-204
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• 1995

• 보건행정학회지
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• 제32권3호
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

• 보건행정학회지
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• 제18권3호
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• pp.90-109
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• 2008

Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.

• 치위생과학회지
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• 제15권6호
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• pp.768-774
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• 2015

본 연구는 만 6세부터 18세까지를 대상으로, 2007~2013년도 국민건강영양조사 원시자료를 이용하여 치면열구전색 수혜량을 파악하고, 수혜량에 미치는 요인을 분석하고자 10,416명을 대상으로 조사하였다. 분석에는 STATA 11.0을 이용하였으며, 분석한 결과 다음과 같은 결론을 얻었다. 7년간의 치면열구전색 수혜량은 평균은 1.12개로 나타났으며, 치면열구전색의 급여화가 시행되기 전인 2007~2009년 11월까지는 평균 0.93개, 급여화 실시 후에는 1.24개로 증가하였다. 일반적 특성에 따른 치면열구전색 수혜량은 소득수준이 높을수록, 건강보험과 민간보험에 가입되어 있을수록, 1일 칫솔질 횟수가 많을수록 높게 조사되었다. 하지만 성별과 연령의 경우는 통계적으로 유의한 차이를 보이지 않았다. 치면열구전색 수혜량에 영향을 미치는 요인으로는 치면열구전색 급여화 여부, 소득수준, 건강보험 유형 및 민간보험 가입 여부, 1일 칫솔질 횟수로 나타났다. 이상의 결과를 종합해보면 치면열구전색 급여화가 시행된 2009년 12월을 기준으로 2010년에 치면열구전색 수혜량 증가를 보이긴 하나, 그 2011년부터는 다시 감소하는 경향을 보이고 있다. 치면열구전색 수혜량을 늘리기 위해서는 치면열구전색 급여화에 대한 홍보를 강화하고, 저소득층에 대한 지원확대 및 사회경제적 수준에 따른 본인부담금 차등화 등의 방안이 논의되어야 할 것으로 생각된다. 또한 치면열구전색 급여화를 시작으로 추후에는 예방처치에 대한 급여화 확대방안에 대해 다각적인 검토가 필요할 것이다.

• 동서간호학연구지
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• 제16권2호
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• pp.172-178
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• 2010

Purpose: We examined the relationship between the health-related issues of elderly women and bone density and identified specific factors that affect the prevalence of osteoporosis to provide basic data for developing a health care program on osteoporosis prevention. Methods: This study is a secondary data analysis of 118,903 66-yr-old women who received a health examination conducted by the National Health Insurance Corporation in 2008. Multiple logistic regression analysis was used to identify factors affecting the prevalence of osteoporosis. Results: The prevalence of osteoporosis was 46.8%, whereas the prevalence of osteopenia was 38.4% among elderly women in this study. Statistically significant differences were observed between the osteoporosis and non-osteoporosis group in terms of smoking (p<.001), exercise (p<.001), obesity (p<.001), waist circumference (p<.001), depression (p<.001), falling experience (p<.05), and the cognitive function risk (p<.05). Based on the multiple logistic regression results, the risk for osteoporosis was high in those who were under-weight, smoked, or were depressed. In contrast, moderate or high level obesity showed a negative relationship with osteoporosis. Conclusion: The prevalence of osteopenia and osteoporosis was 85.2%. Therefore, there is a need to develop health care programs pertaining to osteoporosis intervention and prevention for elderly women. Because smoking, non-exercise, and obesity are main osteoporosis risk factors, it is highly recommended that some sound practical life programs and psychological support programs be considered for this population.