• 한국치위생학회지
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• 제21권1호
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• pp.89-98
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• 2021

Objectives: The purpose of this study was to investigate the perception and satisfaction of caregivers and parents after being covered by health insurance for light-curing composite resin fillings, and to contribute to the settlement of the expansion and coverage of health insurance. Methods: A survey was conducted on caregivers who visited two dental institutions in the Gyeonggi-do area, and parents who joined internet cafes (online communities) in the Gyeonggi-do area from June 2 to September 2, 2020. 225 responses were collected eventually, and 212 valid responses were used as analysis data. Results: 67.0% of the study subjects were aware of the permanent teeth resin fillings being covered by health insurance and the satisfaction was relatively high (91.5%). There was a statistically significant difference in the perception of permanent tooth resin filling benefits according to the child's oral condition (p=0.025) and the parents' own interest in oral health (p=0.039). Conclusions: Based on the results of this study, it is necessary to increase the accessibility to the initial treatment for dental care of children through active promotion of detailed items of permanent teeth resin fillings.

• 치위생과학회지
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• 제14권4호
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• pp.502-509
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• 2014

노인틀니와 임플란트 건강보험 지원사업에 대한 인식과 개선요구도를 조사하기 위해 2014년 6~7월 기간 동안 일부 지역사회의 60세 이상 238명을 대상으로 틀니와 임플란트 보험적용과 개선에 관한 설문조사를 하였으며 다음과 같은 결론을 얻었다. 대상자의 틀니 보험적용 인식은 76.9%였으나 틀니 적용시기와 보험 지원비용의 적절성, 임플란트 보험 적용 인식은 50% 미만으로 낮게 나타났다. 특히 틀니 사후관리 인식은 18.6%로 매우 낮게 조사되었다. 건강보험 급여화 개선요구 조사결과 틀니 적용시기는 60세 이상(42.5%), 임플란트 적용시기는 65세 이상(34.6%)이었고, 건강보험비 자부담은 50% (34.6%)가 가장 높게 조사되었다. 틀니 재제작 기간과 임플란트 지원은 무제한이 각각 32.0%, 47.8%로 가장 높게 조사되었으며, 치과위생사의 구강(틀니) 관리의 참여희망은 94.1%로 높게 조사되었다. 결론적으로 틀니와 임플란트 인식은 높았으나 세부적인 운영사항은 인식하지 못하여 지속적인 정보제공이 필요하며, 건강보험 지원연령을 낮추는 방안이 고려되어 건강보험지원사업의 효율성을 높여야 할 것으로 생각된다.

• 대한한의학방제학회지
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• 제18권1호
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• pp.43-56
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• 2010

Objective : There is a growing need to expand or adjust insurance coverage of herbal prescriptions in National Health Insurance. The purpose of this study was to provide basic data for expansions or adjustments of 56 herbal prescriptions in the National Health Insurance. Method : We surveyed lists of 56 insurance-covered herbal prescriptions, non-covered company-produced herbal medicines and self-prepared herbal medicines in 531 traditional korean medical clinics by mail from 6/1/2008 to 12/9/2008. Result : Among the 56 Prescriptions, Ojeok-san was stocked in 66.7% of clinics (1st), Samso-eum ranked 2nd, Socheongnyong-tang ranked 3rd, Gumiganghwal-tang was 4th, Hyangsapyeongwi-san ranked 5th. Among the non-covered company-produced herbal medicines, Danggwisu-san ranked 1st, Gwakyangjeonggi-san ranked 2nd, Oryeong-san was 3rd, Bangpungtongseong-san was 4th, Maengmundong-tang ranked 5th. Among the self-prepared herbal medicines, Gongjin-dan ranked 1st, Soche-hwan was 2nd, Gyejibongnyeong-hwan was 3rd, Yeongsin-hwan was 4th, Palmi-hwan ranked 5th. Conclusions : It is reasonable to select frequently used company-produced or self-prepared herbal prescriptions in this stock rate survey for improvement of National Health Insurance coverage.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• 대한치과의사협회지
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• 제54권6호
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• pp.457-467
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• 2016

The National Health Insurance Service(NHIS) has been selectively covering the elderly on the dental implant and removable denture treatment and gradually expanding the eligibility criteria. Every dentist needs to have a good understanding of the insurance policy to provide qualified dental service to the beneficiaries and to avoid confusions and complications. In order to help dentists understand the NHIS requirements, the definitions, categories, and procedures of dental implant and conventional denture treatment are suggested.

• 보건행정학회지
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• 제18권3호
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• pp.90-109
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• 2008

Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.

• 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.

• 대한한방부인과학회지
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• 제20권1호
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• pp.239-257
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• 2007

Purpose : In the part of Ob & Gy disease, the health insurance application is very limited. This study has been performed for gaining the basic data of enlargement of insurance coverage and reform of the insurance system corresponded with real clinical conditions. Methods : The survey has been practiced twice, the subjective questionnaire was used at the first survey. Then the questionnaire written using the results of first survey was distributed to the Korean medical doctors(KMD) who participated in the autumn symposium of the society of Oriental Obstetrics & Gynecology. Results : 1. The main Ob & Gy disease that the acupuncture treatment has been used actually or thought be positively necessary on the clinic were Dysmenorrhea(including premenstrual syndrome), Climacteric syndrome, Menstrual disorder, Postpartum Pain syndrome. Amenorrhea, Low back pain with pregnancy, JingHa(pelvic tumor), Infertility etc. 2. The main additional complex the sick and wounded names given to visiting patients for Ob & Gy disease as the limits of acupuncture items of insurance coverage were Low back Pain(J10), Qi-stasis(B13.0), SimHwaHangYeom(C2l.1). 3. Suitable the sick and wounded name of Ob & Gy disease thought be added in BokGangNae(Intra-abdominal acupuncture: CV13 ${\cdot}$CV16${\cdot}$CV10). TuJa(Puncture each adjoining acu-points in one insertion : SP6-GB39), TuJa(PC6-TE5) among acupuncture items of insurance coverage were Dysmenorrhea(K05). Menstrual disorder(K02) and Dysmenorrhea(K05), Hyperemesis(K16.0). 4. Climacteric syndrome(K04) and Dysmenorrhea(K05) should be added as suitable the sick and wounded name of TuJa(SP6-GB39), and Postpartum pain syndrome(K29) as KwanJeolGangNea(Intra-articular acupuncture: S35, LE201). Conclusion : Standing on this study, additional survey to general KMD should be continued. And the academic verifications through the oriental medical literatures and RCT papers on acupuncture should be also required.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8541-8551
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• 2016

Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

• 구강회복응용과학지
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• 제31권3호
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• pp.195-202
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• 2015

목적: 최근 들어 치과에서의 금연치료가 국민건강보험의 적용을 받게 되었다. 하지만 이에 관한 대국민 홍보나 국민들의 인식은 충분하지 못할 것으로 예상된다. 그래서 본 연구에서는 치과 금연치료의 국민건강보험 적용에 관한 환자의 인식도 및 의식 수준에 관하여 조사해 보았다. 연구 재료 및 방법: 실험은 설문조사를 통하여 이루어졌으며, 2015년 3월에 단국대학교 치과대학 부속 치과병원에 내원한 100명을 대상으로 하였으며 18개의 문항의 설문지를 개발하여 시행하였다. 결과: 설문 결과 응답자의 많은 수는 치과 금연치료에 관해 긍정적인 반응을 보였으나, 정책의 시행 사실이나 내용에 관한 지식 및 인식이 상당히 부족한 것으로 나타났다. 결론: 정부와 보건복지부 당국은 새로 시행된 이번 정책의 효율성을 높이기 위해 보다 많은 홍보 활동 등의 노력이 필요할 것으로 사료되었다.