• Title/Summary/Keyword: health insurance coverage

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Awareness & satisfaction of caregivers on the health insurance coverage of light-curable composite resin restoration (광중합형 복합레진 충전 건강보험 급여화에 대한 보호자의 인식과 만족도)

  • Yu, Sl-A;Lee, Su-Young
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.1
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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.

A Study on the Recognition about National Health Insurance Coverage of Denture, Implant of Elderly People (일부 노인층의 틀니, 임플란트 건강보험에 대한 인식도 연구)

  • Oh, Sang-Hwan;Lee, Yu-Jeong;Lee, Yoo-Jin;Lee, Jeong-Mi;Lee, Ju-Hee;Kim, Seol-Hee
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.502-509
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    • 2014
  • The purpose of this study was to investigate the recognition on the national health insurance of denture, implant among the elderly. This survey was performed on 238 of the elderly aged over 60 years in Daejeon. The research was performed using a self-reported questionnaire and interview method from June to July, 2014. The collected data was analyzed using chi-square test, multiple response frequencies by PASW Statistics ver. 18.0. Recognition of national health insurance denture coverage was 76.9%. Channel of information awareness is higher in the media (61.8%). Awareness of application time (36.4%), medical expense by insurance (43.2%) is generally low. And awareness of denture follow up management is significantly low (18.6%). Time of denture and implant coverage needs were over 60 and 65 years old respectively. The respondents want the national health insurance to help medical expenses over 50%. Period of implant and denture re-production required unlimitedness 32.0% and 47.8%, participation to oral hygiene (dentures) management by dental hygienist was 94.1%. In conclusion, denture and implant coverage was higher awareness, but details were not recognized. Therefore, we should provide more detailed information. To increase the efficiency of national health insurance should be considered to lower the coverage age.

The Analysis of Herbal Medicine Preparations Equipped in Traditional Korean Medical Clinics (한방의료기관 한약제제 구비 현황 조사 연구)

  • Bak, Yo-Han;Huang, Dae-Sun;Shin, Hyeun-Kyoo
    • Herbal Formula Science
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    • v.18 no.1
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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.

Changes in Medical Practice Pattern before and after Covering Intraocular Lens in the Health Insurance (인공수정체 보험급여 전.후 진료양상의 변화)

  • Choi, No-Ah;Yu, Seung-Hum;Min, Hey-Young;Chung, Eun-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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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.

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National Health Insurance Coverage for Dental Implant and Denture (진료현장의 건강보험 틀니와 임플란트의 건강보험진료)

  • Choi, Hyeonmi
    • The Journal of the Korean dental association
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    • v.54 no.6
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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.

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The Effect of Expanding Health Insurance Benefits for Cancer Patients on the Equity in Health Care Utilization (건강보험 암 중증질환 급여확대가 의료이용 형평성에 미친 영향)

  • Kim, Su-jin;Ko, Young;Oh, Ju-Hwan;Kwon, Soon-Man
    • Health Policy and Management
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    • v.18 no.3
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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.

Healthcare Utilization and Expenditure Depending on the Types of Private Health Insurance in Korea (민간의료보험 가입 및 가입유형별 의료이용 특성 분석)

  • Lee, Jung Chan;Park, Jae San;Kim, Han Nah;Kim, Kye Hyun
    • Korea Journal of Hospital Management
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    • v.19 no.4
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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.

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A study on the survey for the Application Status and the Improvement of Oriental Medical Health Insurance for the Ob & Gy Disease (부인과 질환에 대한 한방건강보험 적용실태 및 개선방안에 대한 조사연구 1)

  • Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.1
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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.

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Low Coverage and Disparities of Breast and Cervical Cancer Screening in Thai Women: Analysis of National Representative Household Surveys

  • Mukem, Suwanna;Meng, Qingyue;Sriplung, Hutcha;Tangcharoensathien, Viroj
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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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.

Studies on patient's perception and awareness of health insurance coverage for smoking cessation treatment in dentistry (치과내 금연치료 건강보험 적용에 관한 환자 인식도 및 의식 수준에 관한 연구)

  • Cho, In-Woo;Shin, Hyun-Seung;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.3
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    • pp.195-202
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    • 2015
  • Purpose: Recently, smoking cessation treatment at dental clinic can be covered by national health insurance. The aim of this study is to evaluate the awareness on the health insurance coverage for smoking cessation treatment in dentistry. Materials and Methods: The survey was carried out on 100 new patients of the patients in Dankook Dental Hospital from March to April 2015. The Questionnaire consists of 18 items. Results: The results show that many of patients expect positive effects of the treatment but most of the respondents were not aware of the initiation of health insurance coverage smoking cessation treatment in dentistry. Conclusion: The government and ministry of health should pay more attention to the promotion of the smoking cessation treatment in dentistry.