• 제목/요약/키워드: Uncovered services

검색결과 17건 처리시간 0.021초

실손형 민간의료보험의 도입이 국민건강보험 재정에 미치는 영향 (Impact of Complementary Private Health Insurance on Public Health Spending in Korea)

  • 허순임;이상이
    • 보건행정학회지
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    • 제17권2호
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    • pp.1-17
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    • 2007
  • Limited coverage for health care services of National Health Insurance(NHI) in Korea has been ongoing policy issue but additional NHI financing through raising contribution or taxes in order to improve coverage faces substantial obstacles. Private health insurance(PHI) is often considered as an alternative financing source to improve coverage. Recent reform that attempted to stretch the role of PHI allowed life insurance companies to provide complementary PHI, indemnity plan which will pay for uncovered services by NHI and out-of-pocket spending for covered services. Although complementary PHI may relieve financial burden of patients, it may significantly raise NHI spending as well as total health expenditure since little out-of-pocket spending may increase utilization of health care. So far, there has not been enough discussion about concerns of potential adverse effect resulting from extended role of PHI. This study investigated potential increase of NHI spending followed by extension of complementary PHI through sensitivity analysis. The amount of NHI spending for services that would be covered by complementary PHI was calculated using 2005 NHI statistics and expected complementary PHI enrollment rate by age and sex. Expected utilization increases were obtained based on price elasticities$(-0.2{\sim}-0.5)$ from previous studies and expected coverage rate$(50{\sim}80%)$ of complementary PHI and then converted to monetary figures. Because coverage rate of complementary PHI has not been determined yet, we employed the sensitivity analysis using coverage rate of $50{\sim}80%$. Findings demonstrate that additional spending for health care services is expected to be $426{\sim}1,702$ billion won, corresponding amount payed by NHI $298{\sim}1,192$ billion won. In conclusion, since complementary PHI may raise NHI spending significantly, there should be an agreement whether this additional cost would be accountable and acceptable in our society. Potential inefficiency resulting from extended role of complementary PHI should be considered since public and private financing do not operate in isolation and there should be more discussion on proper role of PHI in Korea.

한국인 ABO 유전자 다형성과 이상지질혈증의 연관성 (Association of ABO Genetic Polymorphisms and Dyslipidemia in Korean Population)

  • 송윤주;이성원;진현석;박상욱
    • 대한임상검사과학회지
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    • 제56권1호
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    • pp.66-72
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    • 2024
  • 지질 대사장애는 임상에서 흔히 볼 수 있는 질환이다. 이상지질혈증(dyslipidemia)과 그 유병률은 전세계적으로 심혈관질환의 이환율 및 사망률과 밀접한 관련이 있다. 한국인 대상 40~64세 성인 중년층을 대상으로 ABO 유전자의 다형성과 이상지질혈증과의 연관성을 확인하기 위해 유전자 분석을 실시하였다. 본 연구는 한국인 유전체분석자료(Korean Association REsource, KARE)에서 총 6,750명의 피험자를 선정하였다. KARE 자료의 이상지질혈증 환자 4,403명과 정상 대조군 2,347명의 유전자형 데이터를 사용하여 ABO 유전자의 단일염기다형성(single nucleotide polymorphisms, SNPs)과 유전적 상관관계를 분석하였다. 그 결과 ABO 유전자 중 11개 SNPs 가 이상지질혈증과 통계적으로 유의미한 연관성을 나타내었다. 이 중 ABO 유전자의 rs8176707이 통계적으로 이상지질혈증과 가장 유의한 상관관계를 보였다(P-value=0.002, odds ratio=0.82, 95% confidence interval 0.78~0.86). ABO minor allele T는 이상지질혈증 위험을 감소시키는 것으로 나타났다. 본 연구는 ABO 유전자의 유전적 다형성과 이상지질혈증 사이의 유의미한 연관성을 밝힌 연구이다. 이러한 결과는 ABO의 SNPs가 이상지질혈증의 원인과 유전적 상관관계가 있음을 시사한다고 하겠다.

Key Performance Indicators for Project Management Performance of Large Contractors in Developing Countries: A Case Study in Vietnam

  • Soo-Yong Kim;Troung-Van Luu
    • 국제학술발표논문집
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    • The 3th International Conference on Construction Engineering and Project Management
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    • pp.1599-1607
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    • 2009
  • In order to deal with severe competition in the construction market of developing countries, large contractors must continually improve their own performance and operation. Performance measurement is the heart of ceaseless improvement in organizations. Key performance indicators (KPIs) play a key role in measuring project management performance (PMP) of large contractors in developing countries. The main objective of this paper is to identify KPIs, which can be used to measure PMP of contractors, and then analyze the underlying relationships of these KPIs in order to gain insight into PMP of large construction firms in Vietnam construction industry (VCI). Literature reviews and the pilot survey provided 30 KPIs. Fourteen KPIs, which have the mean values higher than 3.0, were considered as important KPIs through a questionnaire survey of 32 professionals. Factor analysis of these KPIs was employed to categorize them. The results of the survey revealed that top six KPIs are construction time and cost, owner satisfaction on services and products, and quality management and project team performance. Factor analysis uncovered that 14 top-ranked KPIs can be grouped under six categories, namely: (1) construction input management, (2) owner satisfaction, (3) cost and quality, (4) manpower management, (5) subcontractor performance and (6) equipment management. The findings of this research can be used as a guideline to measure PMP of contractors in Vietnam as well as in other developing countries. Since contractors from a country to the other country may have the same manner to manage construction projects, the results of this study may be useful not only to practitioners and researchers in Vietnam but also to participants in other developing countries.

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턱관절 질환의 한의진료 임상현황조사를 위한 웹기반 설문조사 (A Web-based Survey for Assessment of Korean Medical Treatment Clinical Practice Patterns for Temporomandibular Disorders)

  • 김창은;도호정;송현섭;신재권;이원준;김종호;이근재;윤영석;김노현;서창용;이윤재;김미령;조재흥;권미정;하인혁
    • 한방재활의학과학회지
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    • 제28권1호
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    • pp.73-84
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    • 2018
  • Objectives While Temporomandibular disorders (TMD) is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for TMD. Methods A preliminary questionnaire was developed to investigate current practice patterns of TMD treatment and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results The response rate was 2.23%. Most participants replied that they received multiple Korean medicine interventions for TMD treatment consisting of such methods as acupuncture, chuna manipulation, electroacupuncture. The percentage of treatment services among uncovered services, which need to be covered by national health insurance was high in the order of pharmacopuncture, chuna manipulation, and herbal medicine. The most commonly used diagnostic examination tools for TMD was Physical examination and next was Imaging diagnosis. The frequency of TMD treatment was the highest at 2~3 times per week (76%) and the period was from 4 to 12 weeks (63%). Conclusions This survey study helps determine current practice patterns of TMD, and recognizes the need for use of diagnostic devices in TMD treatment. These results are further anticipated to provide basic data for clinical practice guide lines (CPGs).

자폐 장애 아동 보호자의 언어치료 교육 서비스 만족도에 대한 실태조사 (Care-giver Satisfaction of Language Therapy in Children with a Diagnosis of Autism)

  • 김정완
    • 한국콘텐츠학회논문지
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    • 제11권3호
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    • pp.327-338
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    • 2011
  • 본 연구는 자폐 장애로 진단받은 아동의 주양육자 총 52명을 대상으로 현재 받고 있는 언어치료 교육서비스에 대한 만족도와 욕구를 조사하기 위해 실시되었다. 연구방법은 설문조사 방식을 사용하였고, 설문 내용은 치료 교육 기관의 환경(7문항)과 치료사가 제공하는 프로그램(7문항), 그리고 치료 교육 만족도 및 서비스 욕구(7문항)를 포함한 세 가지 측면으로 구분하여 작성하였다. 연구 결과, 치료 교육 기관의 환경면에서, 치료비 등을 이유로 복지관 이용자의 만족도가 가장 높았으며, 사설 치료실, 종합병원 순으로 낮게 나타났다. 치료사가 제공하는 교육 프로그램 면에서, 실시하는 프로그램의 적절성 및 상담 내용 등을 이유로 종합병원 이용자의 만족도가 가장 높았으며, 사설치료실, 복지관 순으로 낮게 나타났다. 치료 교육 만족도 및 서비스 욕구 면에서, 언어치료 및 전체 치료 교육 서비스에 대한 만족도는 다소 만족하는 수준인 것으로 나타났다. 자녀가 언어치료를 받게 되고 난 후, 좋아진 점으로 일상적인 생활 기술의 향상과 심리적 안정이 높게 나타났으며, 추후 받고 싶은 치료 교육과 관련하여 개별, 집단 언어치료 교육 서비스에 대한 욕구가 매우 높게 나타났다. 이상의 결과를 통해, 치료 교육 기관에서 제공하는 서비스의 문제점을 파악하고, 자폐 아동의 치료 교육 만족도를 높이기 위해 언어치료사 및 관련 영역 전문가들이 노력해야 할 여러 가지 함의를 얻을 수 있었다.

관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석 (Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease)

  • 이후연;박은철;박기동;박지은;김영;이상수;강혜영
    • Journal of Preventive Medicine and Public Health
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    • 제36권4호
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

스마트폰을 활용한 항공사의 협업 사례 연구: 훈련 기간과 운영 기간의 차이 분석 (An Asian Airline Implementation of Smartphone Collaboration: From Training to Operations)

  • ;;김용영
    • 한국융합학회논문지
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    • 제9권10호
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    • pp.303-313
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    • 2018
  • 공항에서 품질 높은 서비스를 제공하기 위해 항공사 직원들은 신속하고 효과적으로 지식을 개발하여 공유하여야 한다. 본 연구는 항공사에서 스마트폰을 이용한 협업의 효과를 검증하기 위하여 적응적 구조화 이론과 미디어 일치성 이론에 근거하여 사회적 상호작용, 미디어 일치성, 생산적 산출물로 이어지는 이론적 프레이워크를 개발하였다. 아시아에 거점을 둔 항공사A를 대상으로 훈련 및 운영 기간 동안 33명 인력으로부터 S사에서 제작한 10대의 스마트폰을 이용해 대화한 내용이 담긴 6개월간의 음성 파일을 수집하였다. 근거이론 방법에 기초하여 이론적 프레임워크에 따라 훈련 기간과 운영기간으로 나눠 이 음성 파일을 분류했다. 정성적 정량적 콘텐트 분석에 기반을 둔 훈련 기간과 운영 기간 간 차이 분석결과, 사회적 상호작용 단계에서는 갈등 관리에서 업무 관리로, 미디어 일치성 단계에서는 품질에서 양으로, 생산적 산출물 단계에서는 효율에서 몰입으로 주요한 전환이 발생하였다는 점을 발견하였다. 이러한 결과는 항공사 현업 인력들이 훈련기간 스마트폰 기능의 학습에 중점을 두는 반면, 운영 기간 스마트폰을 활용하여 지식 관리를 수행한다는 점을 시사한다.