• 한국병원경영학회지
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• 제19권4호
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• 보건행정학회지
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• 제24권1호
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

• 한국직업건강간호학회지
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• 제25권2호
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• pp.130-140
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• 2016

Purpose: The construction worker has diverse harmful factors such as noise, dust, and dealing with chemicals. Therefore this research aimed to examine the necessity of appointing a health manager in the construction industry by examining the cost-benefit analysis when the construction industry appoints a health manager. Methods: In order to calculate the healthcare staff employment cost and the benefits from their activities in 1,425 construction companies with the staff of 300 or more people during 2011, this study analyzed existing data and existing research data, as well as national data. Results: Total annual costs were 99,920,070,900 won and total annual benefits were 324,807,182,625 won. Benefits were found to be 224,887,111,725 won exceeding costs. Benefit/cost ratio resulting from appointing a health manager in the construction industry workplaces was 3.25 times. Conclusion: The findings of this research can be used as the base data to make rational decision to positively encourage the employment of healthcare staff in construction companies pursuant to relevant laws.

• Journal of Preventive Medicine and Public Health
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• 제22권3호
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• pp.398-405
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• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• 지역사회간호학회지
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• 제13권2호
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• pp.292-305
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• 2002

Purpose: The purpose of this study was to conduct a systematic assessment on the level of health status, and quality of life of the health care beneficiaries registered in health management programs of public health centers. In order to investigate the level of health status and the quality of life and to find factors affecting them, the PRECEDE model, that was developed by Green, et al. for the purpose of a comprehensive diagnostic research, was used. Method: The subjects were 81 residents who resided K-gu, Seoul. Data were collected from September, 1999 to August, 2000 using a self reported questionnaire. The data were analyzed by descriptive statistics, t-test, Kruskall-Wallis test, Pearson's correlation coefficient. and path analysis. Results: 1. The quality of life and the level of health promoting lifestyle were moderate or more, but were not significantly different by sex, age, marital status, educational level. occupation, and monthly household income. 2. Self-efficacy was significantly correlated to be a perceived benefit, social support and health-promoting lifestyle. Perceived benefit had a significant correlation with social support and health promoting lifestyle. There was also a significant correlation between the level of satisfaction, and the availability of the health promotion program. 3. Social support, health promoting lifestyle, and health status were found to influence the quality of life directly, whereas self efficacy and perceived benefit affected the quality of life indirectly through social support. Conclusion: The results of this study suggest that the health promotion program should include strategies to strengthen self efficacy and perceived benefit to enhance social support, and to encourage health promoting behaviors in order to improve the quality of life of the health care beneficiary.

• Journal of Information Technology Applications and Management
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• 제15권1호
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• pp.183-202
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• 2008

The introduction of a ubiquitous environment has realized commercial ubiquitous services in various industrial fields and government area. The central and/or local governments are demanding an appropriate investment evaluation model for ubiquitous service. Thus, this study develops and suggests an evaluation model for ubiquitous service by reflecting its characteristic of promoting public good, as well as its broad ripple effect on people. The investment evaluation model for ubiquitous service suggested by this study is based on Cost Benefit Analysis Method. Especially, the 'Benefit' is analyzed in two aspects; 'Economic Benefit', which shows the benefit that ubiquitous service providers to the overall local economy, and; 'Financial Benefit', which shows the profit of individual investors participating in the introduction of ubiquitous service. The investment evaluation model for ubiquitous service suggested by this study can be used by the central and/or local government during their evaluation for investment before introducing a ubiquitous service. Also, when introducing a ubiquitous service in public field, the model can be used to support the decision making of private businesses for investment. Finally, it can be used to promote and inform the expected benefits of introducing a ubiquitous service to local residents.

• 한국직업건강간호학회지
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• 제16권1호
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• pp.58-66
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• 2007

Purpose: A national long-term care system for elderly and the disabled has its unique evolution in each country. Japan, Germany and the United States may be the typical examples of respective social insurance system. This paper reviews the counterpart examples of Japan, Germany and the United States and looks at their accumulated long-term care system experiences and personal care system under workers' compensation. Methods: Literature review and website searching were conducted. Key words as 'workers' compensation insurance', 'personal care benefit' and 'long term care' were used in searching the related literatures. Results: Though the personal care benefit under current Workers'Compensation in Korea is very similar to Japan's, the long-term care system of Korea is not as well established. Germany and the United States have the provision of personal care benefit for injured workers within long term care system. Conclusions: We recommend some key issues to take into account for improving personal care benefit system in workers' compensation in Korea as follows: providing a comprehensive coverage through the linkage of long term care, introducing an assessment & evaluation system for the appropriate benefits, establishing insurer's role for quality management of personal care service, and developing a policy for family caregivers.

• 여성건강간호학회지
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• 제16권2호
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• pp.116-125
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• 2010

Purpose: The purpose of this study was to investigate the relationship between health locus of control, exercise self-efficacy and exercise benefits / barriers of female college students. Methods: Convenient sampling was used to recruit participants from a University based in Pusan. Data were collected from October 15 to December 20, 2007, and participants were 322 students. The questionnaires administered consisted of Multidimensional Health Locus of Control (HLOC) Scales, Exercise Self-efficacy Scale, and Exercise Benefits / Barriers Scale. Descriptive statistics, ANOVA, and Pearson's correlation coefficients were used to analyze the data. Results: The mean scores for the HLOC among female students was HLOC-I: 22.24, HLOC-P: 16.82, HLOC-C: 15.16. The mean scores were exercise self-efficacy: 37.45, exercise benefit: 2.96, and exercise barriers: 2.89. The 'double external' response pattern of HLOC was the largest group in female students with significant difference in exercise benefit between response patterns of HLOC. There were significant correlations between HLOC-I, exercise self-efficacy, and exercise benefit/barriers. Conclusion: The results of this study suggest that tailored health management program by pattern of HLOC should be developed to promote the exercise behavior and enhance the exercise self-efficacy and benefit for female students.

• 한국산업보건학회지
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• 제16권4호
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• pp.413-427
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• 2006

It is necessary to study and develop guidelines for providing comfort and health indoor air quality for office workers since air-tight envelope system of current office building may cause poor indoor air quality. The purpose of this study is to propose guideline for volatile organic compounds in office base on the field study, human health risk assessment and cost-benefit analysis. The field study was conducted to survey the concentrations of volatile organic compounds in indoor air of 69 offices from June to September, 2005 in Seoul and Gyeonggi-do. The rate of excess to guideline of volatile organic compounds in indoor air of new apartment on the Ministry of Environment in Korea(MOE) was surveyed 37.6% for benzene, 6.8% for toluene, and 1.5% for ethylbenzene. As the result of human health risk assessment, mean cancer risk did not exceed 10-6 which is guideline of US.EPA. Also, total hazard index did not exceed 1 which is guideline of US.EPA. Through the cost-benefit analysis of angle on the social-economics to verify the necessary to establish the standards of volatile organic compounds for improvement and development of indoor air quality in office, the present value of benefit was higher than the present value of cost. With the above considerations in mind, it is suggested that the field study for indoor air quality in offices should be expanded and human health risk assessment and cost-benefit analysis be performed th offer scientific data for decision-making of policy for improvement and management of indoor air quality in office.

• 지역사회간호학회지
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• 제21권3호
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• pp.362-373
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• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.