• Journal of Preventive Medicine and Public Health
• /
• v.49 no.1
• /
• pp.53-60
• /
• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.

• Journal of Sasang Constitutional Medicine
• /
• v.29 no.4
• /
• pp.299-310
• /
• 2017

The Sasang Constitutional Examination, which is a medical treatment for Korean medicine, is a insurance non-coverage item. It is necessary to diagnose the constitution for medical treatment and to know the health regimen according to the constitution. We plan this project in order to expand the insurance guarantee reinforcement for Sasang Constitutional Examination and Counselling. This study was to investigate the status of insurance coverage and non-coverage items and to investigate objectivity and standardization of Sasang Constitutional Examination and Counselling. In addition, according to medical field, the items of Sasang Constitutional Examination and Counselling were divided. We reviewed the status of constitutional health care services and applied it to the financial budget for the medical care costs. Finally we propose Sasang Constitutional Examination and Counseling of Korean Medicine Act Classification (plan) and propose Insurance Coverage of Sasang Constitutional Examination and Counselling (plan).

• Acute and Critical Care
• /
• v.33 no.4
• /
• pp.230-237
• /
• 2018

Background: Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality. Methods: This was a retrospective observational study of adult patients aged ${\geq}20$ years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses. Results: A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission. Conclusions: Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

• Health Policy and Management
• /
• v.30 no.2
• /
• pp.151-163
• /
• 2020

This study reviewed primary care purchasing issues of the Indonesian single-insurer, BPJS-K, in the context of triangular power relations between the government, the insurer, and the providers, and considered its challenges of purchasing as the national single-insurer. Some literature reviews and interviews with Indonesian stakeholders and residents were used to describe the historical and social contexts of Indonesian healthcare and social health insurance systems especially focusing legal and institutional status of BPJS-K and primary care provision and delivery conditions in remote areas. Though BPJS-K directly belongs to the presidential office of Indonesia, it has limited power in terms of purchasing as a single insurer. Mainly it was due to the lack of primary care resources, Ministry of Health's strong power as the regulator and provider, and BPJS-K's powerlessness against monitoring and quality of care assessment. Ambiguous accountability was another issue among the insurer and the Ministry of Health. This created confusions in primary care provision. It is suggested that each agencies' accountability should be obvious in terms of legal, political, and social contexts.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.12
• /
• pp.5976-5985
• /
• 2012

This study was performed to determine the levels of physical and mental functioning and to reveal its association with related factors in the elderly people received long-term care insurance services. The interviews were performed, during the period from February 16, to March 31, 2011, to 350 elderlies admitted long-term care insurance dwelling in Daejeon city and Chungchung provinces. As a results, the levels of IADL and MMSE-K in the elderly received home care insurance services was significantly higher than that of the elderly received facility care insurance services. But the levels of ADL and CES-D was not significant. Concerning correlation of ADL, IADL, CES-D and MMSE-K, the level of ADL was positively correlated with the level of IADL and MMSE-K, whereas negatively correlated with the level of CES-D. IADL was positively correlated with the level of MMSE-K, whereas negatively correlated with the level of CES-D. As a results of multiple regression analysis, the factors of influence with the level of ADL and IADL were selected the variables of amnesia, regular exercise and MMSE-K. The factors of influence the level of CES-D and MMSE-K were selected the variables of subjective health status, amnesia and IADL. AS a above results, the levels of physical and mental functioning in the elderly people received long-term care insurance services implies closely related with the health status and health-related behaviors.

• Health Policy and Management
• /
• v.27 no.3
• /
• pp.267-271
• /
• 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.

• Korean Journal of Head & Neck Oncology
• /
• v.37 no.1
• /
• pp.11-16
• /
• 2021

Background/Objectives: To analyze changes in the incidence of thyroid cancer for Korean population using big data from the National Health Insurance Service. Materials & Methods: Sample cohort database between January 2004 and December 2013 with 1,000,000 cases for each year was enrolled in this study. Thyroid cancer incidence was analyzed by sex, age and by region. Public health insurance payment was used to reflect socioeconomic status. Results: The incidence of thyroid cancer in Korea increased for 10 years annually. There are 3 times increasing in the incidence rate of thyroid cancer from 2004, 0.03% to 2013, 0.09%. The sex ratio in the incidence rate of thyroid cancer was male : female = 1:7.2 in 2004 and male : female = 1:3.6 in 2013 that suggest decreased gap between the sex ratio. Between 2004 and 2010, the incidence rates of those in their 40s were found to be the highest, whereas the incidence rates for those in their 50s were found to be highest from 2011 and thereafter. Every year the high socioeconomic status group showed a higher incidence of thyroid cancer than low socioeconomic status group. Some specific region showed continuous high incidence of thyroid cancer, not all city and state. Conclusion: The incidence rate of thyroid cancer for 10 years had special feature by sex, age, socioeconomic status and especially by region. This results will be a barometer for further epidemiologic study about the incidence of thyroid cancer for Korean population

• Health Policy and Management
• /
• v.24 no.3
• /
• pp.261-270
• /
• 2014

Background: This study examined what factors affected a complete examination of infant health checkup. Methods: We used Korean national health insurance claim data of 2,936,650 infants, taking examination in 2012. These claim data included enrollment status of householders and records of infant health checkup from 2008 to 2013. Results: Our results shows that for infant characteristics, the likelihood of complete examination of infant health checkup is significantly lower in female, older aged, and handicapped ones. For householder characteristics, the likelihood of complete examination of infant health checkup is also significantly lower in female, older group and self-employed ones. For household characteristics, the likelihood of complete examination is also significantly lower in single-parent families, multi-cultural families, parent with unexperienced health checkup and lower monthly premiums. Conclusion: It is necessary to support an additional use-guide and follow-up management services to improve incomplete examination of infant health checkup.

• Journal of Korean society of Dental Hygiene
• /
• v.13 no.4
• /
• pp.597-604
• /
• 2013

Objectives : The purpose of the study is to compare and investigate oral health status between Korean adults living in Korea and the US. Methods : Subjects were 1,785 persons including 399 Korean adults living in Virginia, US and those from the second year 2011 of the 5th National Health and Nutrition Survey. Darta were analyzed using SPSS 12.0 for frequency analysis, t-test, one-way ANOVA, and post-hoc Tukey. Results : 1. In general characteristics, adult living in Korea revealed higher DT and DMFT than those in the US. 2. In oral health status, adult living in Korea revealed higher DT and DMFT than those in the US. 3. The variables affecting oral health status in Korean adults in the US were age, private health insurance and number of tooth brushing. 4. The variables affecting oral health status in adults in Korea included gender, age, private health insurance, smoking, drinking, use of secondary oral hygienic products and number of tooth brushing. Conclusions : It is necessary to emphasize the importance of oral health care and to establish the oral health education in dental care agencies.

• Journal of Preventive Medicine and Public Health
• /
• v.54 no.5
• /
• pp.293-300
• /
• 2021

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.