• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.1-7
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• 1989

This paper examines the failure to promote adequate preventive health care in the U.S. It focuses specifically on the preventive health services of screening, counseling, and immunization. It explores evidence on their effectiveness, as well as coverage under current private and public health insurance plans. It concludes with a proposal to expand health insurance coverage for preventive services and to reimburse physicians directly for preventive health services provided to patients.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.401-410
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• 2022

Objectives: This study aims to provide data that will improve the scope of national health insurance coverage by surveying the awareness of health insurance benefits, specifically for implants and dentures, among dental workers. Methods: Information was collected through questionnaires completed by 194 dental workers at dental hospitals and clinics. The multiple logistic regression analysis was conducted to confirm influential factors in recognizing the health insurance benefits application for dentures and implants. Results: Regarding the awareness about the validity of health insurance benefits, satisfaction with the appropriateness on the subjects of the denture application and implant application are appeared to be high with each 3.369 and 3.673. Regarding satisfaction with the appropriateness of free post-maintenance for implants, the awareness level regarding the validity of health insurance benefits was indicated as high at 3.673. Conclusions: The categories and levels of appropriate insurance benefits must be restructured continuously.

• The Journal of the Korean dental association
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• v.57 no.11
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• pp.644-653
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• 2019

Since 2013, adults aged over 20 can receive national health insurance scaling once a year in South Korea. In this study, we analyzed the usage status of national health insurance care service for periodontal disease in 2010-2018 by using Healthcare big data of the Health Insurance Review and Assessment Service. The increase rate of the dental care users was very high at 7.8 and 11.2% in 2013 and 2014, respectively. These are higher than the increase rate of all medical institution users, which is between -1.7 and 3.7%. In 2017, the rate of dental use was 44.4%, which has increased more than 10% compared to 2012. Percent receiver of national health insurance scaling was 19.5% in 2017. The 20s had the highest rate of 23.2%. The rate decreased with age. Based on these results, it can be evaluated that the expansion of national health insurance coverage for scaling improves accessibility to dental care. A more long-term assessment of the effect of periodic dental examination and scaling on reducing the prevalence of periodontal disease is needed. National health insurance coverage should be extended to oral hygiene education and supportive periodontal therapy in order to prevent periodontal disease.

• Dementia and Neurocognitive Disorders
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• v.16 no.1
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• pp.1-6
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• 2017

The purpose of this study is to examine interventions and supporting systems by dementia stage, take a look at dementia insurance policies in Korea and the United States, and present Korean private insurance programs for dementia patients. According to the study, our suggestions of a design of private insurance products for Korean dementia patients are as follows. First, the products should support people aged 80 and older. Second, new products should include the mild stage dementia in the insurance coverage. Third, non-pharmacological treatments, such as the cognitive stimulation, the cognitive training, and exercises need to be covered through the new private insurance. Fourth, the private insurance should be contained home health care services in its coverage. These suggestions can reduce the dependence of the public insurance, help people choose appropriate treatments for themselves, and give people a good opportunity to improve the effect of dementia treatment and to increase the satisfaction of patients and their families.

• Journal of Sasang Constitutional Medicine
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• v.23 no.1
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• pp.8-11
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• 2011

1. Objectives: Sixty eight kinds of single herbal medicine extracts and fifty six kinds of mixed herbal medicine extracts have been used under a national health insurance since 1987. The number of herbal medicine extracts under an insurance coverage remains unchanged. The demand for covering complex herbal medicine extracts and Sasang Constitutional medicine extracts in a national health insurance increases. This study is to investigate the needs for the insurance coverage. 2. Methods: Advantages and disadvantages between herbal medicine decoction and extracts were explained and Sasang Constitutional medicine extracts according to Sasang constitution were surveyed in production nowadays. 3. Results: Herbal medicine decoction has many advantages of treating patients but herbal medicine extracts have advantages of the rapid adminstration and being easy to carry. From eleven to twenty two products of Sasang Constitutional medicine extracts have been in production in several factories. There are eleven kinds of Soyangin medicine extracts, nine kinds of Taeeumin medicine extracts and five kinds of Soeumin medicine extracts. 4. Conclusions: Complex herbal medicine extracts and Sasang Constitutional medicine extracts have to be in use under a national health insurance as soon as possible.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.2
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• pp.1-10
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• 2019

Backgrounds : In 2017, National Health Insurance implemented the pilot coverage program for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the program to monitor the effectiveness and patients' satisfaction of insured CMT. Objectives : This study aimed to evaluate patients' satisfaction of CMT in the pilot coverage program of National Health Insurance. Methods : Survey participants were recruited among the patients who used CMT at the designated organizations. On-line questionnaire link was sent to the smart phones of patients who agreed to participate in the survey and provide personal contact information. The questionnaire consisted of the basic charactersitics of respondents, imformation on using CMT satisfaction with CMT and willingness to recommend CMT to others. The answers that were automatically coded and saved were statistically analyzed. Results : Of 386 participants who completed the questionnaire, 92.8% satisfied or strongly satisfied with the CMT. Most frequent reason of satisfaction was 'Good effectiveness', and there was no difference in satisfaction between patients of hospital and those of clinics. Patients with the highest and the lowest level of pain satisfied more than those with other pain levels(p=0.003), but the level of copayment and reasons of CMT use did not affect the satisfaction results(p=0.405). The proportions of respondents who had willingness to recommend CMT to others and to revisit for CMT use were 97.8% and 98.8%, respectively. Conclusions : Most patients were satisfied with CMT in the pilot coverage program, and it can provide the rationale for expanding the insurance coverage of CMT to all KM hospitals and clinics.

• Journal of Convergence for Information Technology
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• v.11 no.10
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• pp.194-204
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• 2021

This study was conducted to find out the status and factors of private health insurance subscriptions by life cycle and to identify differences in medical usage behavior by life cycle. Using the SPSS 26 program as the 12th-15th (2016-2019) data of the Korea Welfare Panel, the difference subscriptions was identified as Chi-square by demo social and health characteristics of 58,223 people, and the factors affecting subscription were analyzed by polynomial logistic analysis and average analysis was performed for medical use behavior. As a result of the analysis, the biggest factor in purchasing private health insurance was household income, private health insurance coverage is the highest in growth period, and multiple subscriptions were made depending on household income. In youth, household income, spouse, and no disability, and middle age, household income, economic activities, spouses, and health levels were largely influential factors. The rate of private health insurance coverage in old age was the lowest, and low-income households, poor health levels, and people with disabilities were lower. The increase in medical use by private health insurance subscribers also occurred during growth and youth. It is necessary to strengthen the national health insurance coverage, and the role of private health insurance to supplement it should be established in time for the life cycle to complement each other, eliminating blind spots of medical security and maximizing people's health and well-being.

• The Journal of Korean Medicine
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• v.39 no.3
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• pp.51-60
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• 2018

Objectives: This study aimed to investigate the opinions of Korean medical doctors on how to elucidate possible remedial measures for expanding the health insurance benefits coverage item of Korean medicine (KM). Methods: An online survey was conducted to all members who had registered e-mail address in the association of Korean medicine from 1 to 17 November, 2016. Statistical analysis was performed and odds ratio with 95% confidence interval were calculated by each subgroup. Results: A total of 743 members answered the questions and the response rate was 4.1%. The priorities for expanding health insurance benefits were as follows: thermographic imaging, Sasang constitution typing test, and pulse wave among examinations; pharamacopuncture, embedding acupuncture, and acupotomy among procedures; Chuna manual therapy, manual therapy for meridian muscle, and Daoyin exercise therapy among manual therapies; low-frequency electrical therapy, traction, paraffin bath, and light therapy among physical therapies; and aromatherapy, enema therapy, and color therapy among activities of KM. Conclusions: It should be covered by the national health insurance (NHI) of KM that thermographic imaging, pharmacoacupuncture, Chuna manual therapy, low-frequency electrical therapy, aromatherapy as a top priority. We also suggest that basic medical tests, such as blood, urine, or imaging, should be included in the coverage of the NHI of KM. It is necessary to review the expertise and public opinions about the plans and priorities for the conversion of the desired medical services to be covered by the NHI.

• Journal of Technologic Dentistry
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• v.38 no.1
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• pp.9-22
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• 2016

Purpose: The Purpose of this study are to describe the Dental field of present health insurance for custom-made prosthetic implant by dental technicians' work. Results: A total of 300 dental technicians working at dental laboratories in Korea were randomly selected and surveyed, 206(68.7%) of them were used for the statistical analysis. Conclusion: Average daily working time was 10 hours 66%. The average cumulative credit of the clinic for dental prosthesis fabrication rates was Less than 10 million won(21.8%), 10~80 million won(11.7%), more than one hundred million won(1.5%). Remake dental prosthesis was one more than the monthly average of 98.5%. Causes of remake dental prosthesis was dentist impression 83% but did not pay 62.5%. Dental technicians Implant production period was 7 days(48.5%), 10 days(35%) was commissioned by dentists production time is 5 days(46.1%), 7 days(36.5%). President of dental laboratories 3.86 points and dental technicians 3.06 points knew differently about starting of implant health insurance coverage(p<.001). They alike were in favor of insurance coverage for the implant. Dental technicians were lower by 2.36 points for work do you know whether your health insurance application of dental prostheses. Dental technicians are 2.16 points on whether confidence in the pores payment of insurance coverage dental prosthesis, dental laboratory president was lower by 1.85 points. They are very low with 1.97 points on whether confidence in the rate payment of health insurance coverage dental prosthesis(p<.01). The implant prosthesis abutment selected, the abutments designed, design of the implant upper prosthetic, the upper prosthetic fitting dental technicians participate of dental laboratory president showed higher score (p <.05). Conclusion: Hours of dental technicians were making this short period of remake dental prosthesis-related dental prosthesis. Dental clinic and a detailed representation of the dental prosthodontic fabrication request is required for communication between the laboratory in order to reduce the remake of a dental prosthesis, dental insurance coverage written dental prosthodontic fabrication request should be legislated. Implant classification standard medical practice 1-3 Step conduct a thorough costing a total of no. 73 of the correct classification standard medical practice in addition to eight times defined by the act of dental technicians should be defined.

• Health Policy and Management
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• v.24 no.3
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• pp.205-218
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• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.