• 한국의료질향상학회지
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• 제28권2호
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• pp.30-38
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• 2022

Purpose: The Health Insurance Review and Assessment Service (HIRA) in South Korea initiated a quality assessment (QA) program for blood transfusion healthcare services in 2020 to ensure patient safety and appropriate blood use. This study examines the quality of blood transfusion services since the first national QA program for blood transfusion services in Korea. Methods: We analyzed HIRA claims and QA investigation data based on inpatient medical records from all tertiary, general, and primary hospitals between October 2020 and March 2021. The target population was patients aged 18 years and older who received either total knee arthroplasty or red blood cell transfusion. The QA indicators for transfusion healthcare service consisted of four quality indicators and four monitoring indicators. Results: We analyzed the results of QA indicators for transfusion service from the medical records of 189,668 patients from 1,171hospitals and expressed indicators as proportions. The average results for evaluation indicators were as follows: transfusion checklist presence, 64.8%; irregular antibody tests, 61.8%; transfusions in which the hemoglobin levels before transfusion met the transfusion guidelines for patients undergoing total knee arthroplasty, 20.6%, and transfusions in patients undergoing total knee arthroplasty, 59.3%. The average results for monitoring indicators were as follows: transfusion management implementation in medical institutions, 56.9%; preoperative anemia management in anemia patients undergoing total knee arthroplasty, 43.9%; one-unit transfusions, 82.5%; and the transfusion index. Conclusion: The quality of blood transfusion healthcare varied and the assessment revealed that there is scope for improvement. Hospitals require more effective blood transfusion management and this can be facilitated by providing feedback on the QA results about blood transfusion healthcare services to medical institutions, and by disclosing the results to the public.

• 대한영상의학회지
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• 제81권5호
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• pp.1024-1037
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• 2020

상대가치란 소모된 자원의 양을 기준으로 의료행위의 가치를 상대적으로 비교한 점수로 의사업무량, 진료비용, 위험도로 구성된다. 2차 상대가치 개정 당시 영상검사 수가는 높은 원가 보존율을 이유로 인하되었다. 영상검사 수가는 상대가치 체계에서 진료비용이 대부분을 차지하고 있으며, 의사업무량은 상대적으로 저평가되어 있다. 문재인케어라고 불리는 새로운 건강보험 보장성 강화 대책은 비급여의 급여화, 본인부담금 상한제 확대, 재난적 의료비 지원을 골자로 국민의 의료비 부담을 줄이는 것이 목표이며 향후 건강보험 재정에 부담이 늘어날 것으로 우려된다. MRI와 초음파 검사 급여 확대는 문재인케어에서 큰 비중을 차지하고 있으며 영상의학과는 문재인케어 적용 과정에서 저평가된 영상검사에서의 의사의 노동을 적절히 평가받을 수 있도록 노력해야 한다.

• 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.

• 가족자원경영과 정책
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• 제26권3호
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• pp.49-64
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• 2022

이 연구는 우리나라 노인들을 의료취약성 정도에 따라 네 집단으로 세분화하여 경제적, 비경제적 사유로 인한 미충족의료 경험 차이를 분석하고, 이에 따른 정책적 시사점을 도출하였다. 2018년 한국의료패널 자료를 사용하였으며, 65세 이상 노인 4,147명에 대해 분석을 실시하였다. 노인들을 세분화한 결과, 일반건강보험가입자가 79.6%, 비수급빈곤층이 13.6%, 차상위경감대상자가 1.1%, 의료급여수급자가 5.7%의 비율을 차지하였다. 분석결과에 따르면, 병의원 또는 치과진료에 대해 노인들의 12.6%는 경제적 사유로, 10.6%는 비경제적 사유로 미충족의료를 경험한 것으로 나타났다. 의료취약계층 노인의 미충족의료 경험률은 비취약계층인 일반건강보험가입자에 비해 전반적으로 높았는데, 이는 대부분 경제적 사유에 따른 경험률 차이에서 비롯된 것이었다. 경제적인 사유로 인한 미충족의료 경험률은 일반건강보험가입자가 9.8%였던 반면, 비수급빈곤층은 18.9%, 차상위경감대상자는 40.0%, 의료급여수급자는 31.5%로 큰 차이가 있었다. 다른 영향요인을 통제한 로지스틱 분석 결과, 모든 의료취약계층이 일반건강보험가입자에 비해 경제적 사유로 미충족의료를 경험할 확률이 유의하게 높았는데, 비수급빈곤층은 약 1.4배, 차상위경감대상자는 3.3배, 의료급여수급자는 2.4배 높아졌다. 반면, 비경제적 사유로 인한 경험은 일반건강보험가입자 대비 의료급여수급자의 경우에만 1.7배 증가하였고, 다른 집단에서는 유의한 차이가 없었다. 이를 바탕으로 본 연구는 의료취약계층 노인들의 필수적 의료자원 보장을 위한 정책적 시사점을 제시하였다.

• 보건행정학회지
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• 제29권2호
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• pp.146-159
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• 2019

Background: The purpose of this study is to measure the Korean health literacy level and to analyse its gaps according to the factors of socioeconomic and health status and health behaviors. Based on this, policy implications were reviewed to improve the understandability on health information and to reduce the gap among socioeconomic groups. Methods: HLS-EU-Q47, a tool developed by the European Health Literacy Project, was used to conduct a face-to-face interview survey on the health literacy for the samples from general population. Results: The public general health literacy (HL) index was 34.5 out of 50. HL is consisted of three sub-dimensions: healthcare (HC-HL), disease prevention (DP-HL), and health promotion (HP-HL). And a HL analysis found scores of 34.7 points for HC-HL, 35.4 points for DP-HL, and 33.3 points for HP-HL. The level of all HL was different according to socioeconomic characteristics and health behavior. Conclusion: Based on the results of this study, more research activities on health-related literacy need to be conducted, and monitoring system on the HL level needs to be developed and implemented. In addition, a program to improve HL levels needs to be developed in order to strengthen the basis for a more sustainable healthcare system as an agenda with national health policy priority.

• 지역사회간호학회지
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• 제20권2호
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• pp.134-142
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• 2009

Purpose: This study was to present the process of web-based educational program (WEP) development and to identify factors affecting satisfaction with WEP for the certificate of healthcare managers working at the National Health Insurance Corporation (NHIC). Methods: Subjects were healthcare managers and voluntary participants of WEP. A total of 1,449 respondents were surveyed through an online questionnaire about their satisfaction with the educational contents and system. Results: The mean contents satisfaction was 3.75 (SO 0.54), and system satisfaction 4.68 (SD 0.54). According to statistical analysis, the type of certification, experience and professional career of health care management affected contents satisfaction. And factors affecting system satisfaction were the type of certification and gender. Conclusion: WEP was utilized as a pre-requisite course for the certificate program of healthcare managers. However, the development of advanced WEP is suggested to meet the educational needs of healthcare managers who have certificate or license and their job related to healthcare management.

• 한국치위생학회지
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• 제16권2호
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• pp.185-193
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• 2016

Objectives: The purpose of the study was to examine the recognition and satisfaction of dental care customers after 1 year national health insurance coverage of dental scaling. Methods: A self-reported questionnaire was completed by 477 dental care customers in Gyeongbuk, Busan, Yangsan, and Gyeonggido from July 18 to September 30, 2014 after receiving informed consents. The questionnaire consisted of general characteristics of the subjects(5 items), subjective awareness of oral health(4 items), recognition of scaling(5 items), and recognition and satisfaction of scaling health insurance(5 items). Data were analyzed using SPSS version 20.0 program. Results: Those who recognized the national health insurance coverage of dental scaling accounted for 80.1 percent and 47.2 percent of them got the health insurance coverage via media advertisements. Those who received the scaling service by health insurance coverage accounted for 73.8% and 66.2% of them were very satisfied with the service. Among the customers, 91.8% were satisfied with scaling health allotment. There was a statistical significance between scaling health insurance and subjective oral condition recognition(p<0.01). Through the health insurance coverage scaling service, the oral health in Korea will improve much. Conclusions: The expansion of health insurance coverage of scaling service will provide the universal oral health care for all people. Owing to low cost service, people will actively try to come in contact with public health service in the future.

• Tuberculosis and Respiratory Diseases
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• 제52권6호
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• pp.579-589
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• 2002

Since the inception of the National Tuberculosis Control Program in 1962, the incidence of tuberculosis and its associated mortality has declined dramatically due to effective anti-tuberculosis drugs and a systematic control program. The prevalence of radiographically active tuberculosis has fallen from 5.1% in 1965 to 1.0% in 1995. However, tuberculosis is still a major problem, as the mortality rate is still higher compared to other developed countries. Furthermore, tuberculosis is currently re-emerging in HIV/AIDS epidemic countries. In order to lower the tuberculosis death rate to the levels of developed countries, the tuberculosis control efforts in private healthcare institutions and the national tuberculosis control program in the public sector, need to work together more effectively and efficiently. In this paper, the quthor reviewed the current situation regarding tuberculosis management in private healthcare institutions of Korea based on the literature and the National Health Insurance Claim data, and the future tasks of tuberculosis management are suggested.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제14권4호
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• pp.21-30
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• 2008

Domestic hospital architectures were developed with the nation's industrialization after 1960s. Particularly, with the rapidly growing healthcare demands according to The National Health Insurance Plan which was introduced in 1977 and expanded to entire nation in 1989, the number of healthcare facility is also increasing according to the expansion of the existing facilities and construction of new buildings. Now, twenty to thirty years were past since that growing period of healthcare architecture. Many hospitals are facing on the phase of restructuring and modernization for their resources. J university hospital is a representative case of hospital development which the growth of facility was stopped by insufficient site area. This study, analysing its past statistics and drawing data of that hospital, presents the characteristics of the changes and basic data of the master planning for the future hospital development.

• 보건행정학회지
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• 제27권3호
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• pp.267-271
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• 2017

This year marks the 40th anniversary of the introduction of National Health Insurance (NHI) which has contributed to improving public health and accessibility. This article aims to show the trends of main indicators during the last 40 years. NHI has achieved rapid expansion of target population (1977-1989). The percentage of population covered increased from 8.8% in 1977 to 94% in 1990. The average number of visit days per person was 0.75 in 1977 but significantly increased to 31.11 in 2015. In 2015, NHI revenues were 52.4 trillion won and expenditures were 48.2 trillion won which is 9.5 times and 9.6 times higher than in 1995. NHI achieved universal coverage in short period of time and has contributed to improving the healthcare status. However, there still remain problems including low-benefit coverage and high out of pocket money. Therefore, the effort to reform these problems is needed.