• Health Policy and Management
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• v.29 no.2
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• pp.172-183
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• 2019

Background: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. Methods: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. Results: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. Conclusion: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.401-410
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• 2022

Objectives: This study aims to provide data that will improve the scope of national health insurance coverage by surveying the awareness of health insurance benefits, specifically for implants and dentures, among dental workers. Methods: Information was collected through questionnaires completed by 194 dental workers at dental hospitals and clinics. The multiple logistic regression analysis was conducted to confirm influential factors in recognizing the health insurance benefits application for dentures and implants. Results: Regarding the awareness about the validity of health insurance benefits, satisfaction with the appropriateness on the subjects of the denture application and implant application are appeared to be high with each 3.369 and 3.673. Regarding satisfaction with the appropriateness of free post-maintenance for implants, the awareness level regarding the validity of health insurance benefits was indicated as high at 3.673. Conclusions: The categories and levels of appropriate insurance benefits must be restructured continuously.

• The Journal of Korean Medicine
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• v.28 no.3 s.71
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• pp.244-260
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• 2007

Objectives : The purpose of this study was to provide lawmakers with basic data for the purpose of establishing a policy on health insurance for packed herbal medicine. Methods : To properly execute an insurance system for packed herbal medicine, we surveyed the following questions from May 1st to June 15th, 2006: (1)the way to pay the insurance benefits (2)specific impression (disease) names as related to insurance (3)the range of insurance coverage. We obtained answers from 304 Korea traditional doctors. Results : 89.4% respondents were agreed on execution of health insurance for packed herbal medicine. 93.86% respondents answered that the way to pay insurance benefits and the range of insurance coverage have to be changed properly. Most respondents answered that the coverage should be based on a specific disease being treated, not the current symptoms method which relates to the prescription. The execution of health insurance for packed herbal medicine is expected to increase the number of patients and make the Korean medical system more popular. Conclusion : The findings are expected to make it easier for the general public to get treatment by providing basic data with policy makers that will cover packed herbal medicine in insurance. Also, a proper Korea traditional health insurance program should be set up as soon as possible to widen the choice of medicine for the general public.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.38-47
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• 2020

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

• Korean Journal of Occupational Health Nursing
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• v.25 no.1
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• pp.19-28
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• 2016

Purpose: This study was a descriptive research to identify the effects of communication skills, compassion satisfaction, compassion fatigue on burnout among staff of long term care insurance for the elderly in National Health Insurance Services in Korea. Methods: A descriptive cross-sectional design was used. The participants were 191 staffs of long-term care insurance in National Health Insurance Services. Data were collected via mail from the 24 branch offices which were randomly selected among the total of 226 centers of National Health Insurance Corporation. Stamm's professional quality of life (ProQOL) and Communication Skills Test tool were included in questionnaire to detect. SPSS/WIN 20.0 was used to conduct the descriptive statistics, t-test, ANOVA, correlation analysis, and multiple regression. Results: Compassion fatigue had a significant positive effect on burnout, while Compassion satisfaction had a negative effect on burnout. The explained variance for burnout was 69% and compassion fatigue was the most significant factor in burnout among staff of long term care insurance services. Conclusion: The results indicate that the factors influencing staffs' burnout are compassion fatigue, compassion satisfaction, and education level. Therefore, strategies to decrease compassion fatigue and improve compassion satisfaction are needed to decrease burnout for staffs of long-term care insurance in National Health Insurance Services.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.124-130
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• 2018

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

• Journal of Korean Public Health Nursing
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• v.30 no.3
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• pp.512-525
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• 2016

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

• Journal of Technologic Dentistry
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• v.32 no.1
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• pp.35-43
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• 2010

Purpose: The purpose of this study is dental technicians perception investigation about national health insurance of old persons denture in metropolitan area. Methods: A survey was performed on 103 subjects in metropolitan from January 14 to April 30 in 2009. The research tool was a structured questionnaire. The collected data was analyzed by frequency, descriptive and multiple linear regression. Results: Total dental technician who respond to questionnaire was 103(100.0%). Male respondent appeared by 66.0%. 30-year-old low respondent appeared by 60.2% and subjects lived the most in seoul(68.0%). When got married, was expose that realization about national health insurance of old person s denture was high(p<0.05). When made denture, was expose that realization about national health insurance of old person s denture was high(p<0.05). Also, When got married, was expose that necessity about national health insurance of old persons denture was high(p<0.001). Conclusion: When did national health insurance of old persons denture, there were a lot of problems. But, old people was need it. Therefore, I desire that this study is used to basic data of the national health insurance.

• Journal of Korean society of Dental Hygiene
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• v.24 no.1
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• pp.9-16
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• 2024

Objectives: The demand for dental care is expected to increase as the population ages. This study aimed to predict the utilization of dental implant care following the expansion of national health insurance benefits for dental implants. Methods: Multiple linear regression analysis was performed on HIRA big data open portal data and DNN-based artificial intelligence models to forecast the utilization of dental care in relation to the national health insurance coverage for dental implants. Results: National health insurance coverage of dental implants was found to be associated with the number of patients using dental implant services and demonstrated a statistical significance. The dental implant services utilization increased with the increased dental implant health insurance benefits for the elderly population, increased mean by region, increased number of dental institutions by region, and increased health insurance coverage rate for dental implants. However, the dental implant services utilization decreased with the increased number of older people living alone and increased size of dental institutions. Conclusions: With the expansion of the national health insurance coverage for dental implants, it is predicted that the utilization of dental implant medical services will increase in the future.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.438-446
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• 2006

Objectives: We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. Methods: The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. Results: This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). Conclusions: Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.