• Journal of Multimedia Information System
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• 제8권1호
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• pp.69-74
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• 2021

This paper accumulates the product structure data such as bond obligation ratio and investment ratio for variable insurance using crawling from the insurance company's API, also accumulates variable insurance income and project expenses for variable insurance using crawling from the API of life insurance association. From these accumulated data, the correlation coefficient between fund product and customer preference is calculated with an investment algorithm, and variable insurance funds by customer investment preference and product structure are recommended according to market conditions. From the simulation results, it is shown that the proposed variable insurance management system properly recommends and manages variable insurance according to customer preferences.

• 재무관리연구
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• 제20권1호
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• pp.279-304
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• 2003

예금보험료는 각 금융기관의 위험정도에 상응해서 부과되어야 하지만 우리나라는 현재 금융 업종별로만 차등화되어 있고 같은 업종 금융기관간에는 동일 예금보험료율이 적용되고 있다. 고정예금 보험료율 부과방식에 비하여 변동예금 보험료율 부과방식은 논리적 타당성을 지니고 있지만 실제 적용가능한 객관적이고 측정이 용이한 기준마련이 어렵다. 본 연구에서는 옵션평가모형(option pricing model)을 이용하여 1995년부터 2001년까지 개별금융기관 및 전체 금융업종별로 예금보험료율을 추정하고 분석하였다. 금융업종별로 상호비교한 다음 연도별 추세분석과 분포분석을 하였다. 다음으로 추정 예금보험료율과 은행의 자본적정성, 수익성 및 자산건전성을 나타내는 관련 변수들과의 상관관계를 분석하였다. 연구 결과 개별 금융기관에 따라, 그리고 금융업종 및 표본기간에 따라 예금보험료율의 추정치가 상당한 차이를 보였다. 이는 금융업종에 따라 예금보험료율을 차등부과하고 개별은행의 위험을 반영하는 위험반영 차등 예금보험료율 제도의 타당성을 뒷받침한다고 할 수 있다. 은행보고자료와 감독기관의 검사자료가 지니고 있는 주관적 요소라는 단점을 극복하는 자료인 시장자료를 이용하는 본 연구의 추정결과는 예금보험료 부과에 보완적으로 사용할 수 있을 것이다.

• 보건행정학회지
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• 제30권2호
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• pp.178-184
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• 2020

Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

• 보건행정학회지
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• 제16권3호
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• pp.37-51
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• 2006

This study evaluates the reliability of the discharge status variable m health insurance claims for identifying in-hospital patient deaths. This study used 2002 national health insurance claims and the cause of death statistics from Korean national statistical office. The Study data set included acute myocardial infarction (AMI) and coronary artery bypass graft (CABG) surgery patients in 133 general and tertiary hospitals. The gold standard containing patient death information was made and then compared with that of claims data. The hospitals were classified into four groups based on the number of deaths in each hospital. Simple kappa coefficients were calculated to evaluate the agreements of patient deaths between the gold standard and the insurance claims. CABG (83.9%) showed higher agreements than AMI(73.0%) in matched in-hospital patient death information between data sets. Simple kappa coefficients of CABG (0.63) and AMI (0.59) showed moderate or good agreements. The agreements, however, varied depending on the disease or hospital types. The fact that the agreements are only moderate to good indicates that the accuracy of in-hospital death information in claims is not high. n the variable is used to identify patient deaths, it may mislead people. Therefore, efforts should be made to improve the reliability of the discharge status variable in health insurance claims.

• 한국병원경영학회지
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• 제22권2호
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• pp.58-69
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• 2017

Recently, with the increase in the number of private health insurance subscribers, interest in overuse of the medical service is increasing. This study analyzed the impacts of private health insurance (PHI) on medical institution selection in outpatient service utilization among persons with arthritis. In order to control patients' health status, we extracted outpatient episodes with the same disease (KCD6, M13) from Korea Health Panel. The unit of analysis was an outpatient visit with arthritis in 2014 (n=23,363). In the light of insurance coverage, we redefined three type of private health insurance (ex, indemnity, fixed benefit, and non-insured) as a test variable and two type of medical institution (ex, hospital and physician visit) as a dependent variable. We conducted a probit regression analysis to identify the impacts of PHI on medical institution selection controlling for heteroscedasticity. The results of this study showed that the insured with indemnity were more likely to choose hospital departments than clinics (marginal effect=0.0475, p=0.000). The impact of participation of fixed benefit PHI was not as clear as that of indemnity type (marginal effect=0.0162, p=0.047). In conclusion, this study confirmed that PHI, particularly indemnity type has a significant impact on the selection of medical institutions. Healthcare policy makers should consider that PHI not only affects the overall quantitative increase in healthcare utilization, but also influences the selection of medical institutions.

• Journal of the Korean Data and Information Science Society
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• 제19권4호
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• pp.1007-1018
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• 2008

The purpose of this case study is to demonstrate database-marketing management. First, we explore original variables for insurance customer's data, modify them if necessary, and go through variable selection process before analysis. Then, we develop churn prediction models using logistic regression, neural network and SVM analysis. We also compare these three data mining models in terms of misclassification rate.

• 보건행정학회지
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• 제30권1호
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• 한국병원경영학회지
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• 제24권1호
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• pp.48-56
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• 2019

Purpose: As an interest in the elderly medical expenses increases, elderly people are increasingly purchasing indemnity private health insurance. Authors tried to investigate factors of having the indemnity private health insurance among the elderly people aged 65-75 years. Methods: We conducted panel logit regression analysis on 2,465 subjects as of 2016 using Korean Health Panel from 2010 to 2016. The dependent variable was whether to enroll in the indemnity private health insurance. The explanatory variables included socio-demographic characteristics, economic factors, health status, and health behaviors. Findings: As a result of the analysis of factors of purchasing indemnity private health insurances, it was analyzed that people with larger family, educated, pensioner, high household income or no disability were more likely to have indemnity private health insurance. Practical Implications: Considering the results of this study, the factor of purchasing indemnity private health insurance among elderly people were more likely to be their economic than demographic characteristics such as sex, age, and marital status. Policy makers should make efforts to reduce the burden on the elderly medical expense and to improve equity of medical use through institutional improvement such as raising age limit and lowering premium of indemnity private health insurance and expansion of public health insurance.

• 디지털융복합연구
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• 제11권7호
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• pp.59-66
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• 2013

보험은 위험보장이라는 본래의 기능으로 세법에서 다른 금융상품보다 우대되어 왔다. 그러나 최근의 보험상품은 위험보장 뿐만 아니라 투자기능 및 저축기능이 결합된 다양한 방식으로 출시되고 있다. 더욱이 보험사의 판매방식이 절세전략, 조세회피 등과 관련된 컨설팅 등을 포함하고 있어 저축성 보험차익의 비과세와 관련된 조세정책에 비판이 제기되어 왔다. 이에 정부는 고액자산가의 조세회피방지와 타금융상품 간의 형평성 등을 위하여 2013년 소득세법 시행령 제25조를 개정하였지만 여전히 많은 문제점이 존재하고 있다. 본 연구에서는 저축성 보험차익에 대한 조세정책의 타당성을 2013년에 개정된 소득세법 시행령을 중심으로 살펴보고 이에 대한 개선방안을 도출하고자 하였다.

• Journal of applied mathematics & informatics
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• 제32권3_4호
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• pp.343-357
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• 2014

In many non-life insurance applications past data are given in a form known as the run-off triangle. Smoothing such data using parametric crisp regression models has long served as the basis of estimating future claim amounts and the reserves set aside to protect the insurer from future losses. In this article a fuzzy counterpart of the Hoerl curve, a well-known claim reserving regression model, is proposed to analyze the past claim data and to determine the reserves. The fuzzy Hoerl curve is more flexible and general than the one considered in the previous fuzzy literature in that it includes a categorical variable with multiple explanatory variables, which requires the development of the fuzzy analysis of covariance, or fuzzy ANCOVA. Using an actual insurance run-off claim data we show that the suggested fuzzy Hoerl curve based on the fuzzy ANCOVA gives reasonable claim reserves without stringent assumptions needed for the traditional regression approach in claim reserving.