• Archives of Plastic Surgery
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• v.45 no.3
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• pp.239-245
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• 2018

Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05). Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05), but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05). Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

• Restorative Dentistry and Endodontics
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• v.17 no.2
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• pp.431-438
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• 1992

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1024-1037
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• 2020

The resource-based relative value scale (RBRVS) compares the value of a medical practice to the consumption of resources, which consist of the work of the physician, practice expenses, and professional liability insurance. At the time of the 2nd revision of RBRVS, the fee for radiological examinations had been reduced due to the high preservation rate. In RBRVS, practice expenses account for most of the compensation of radiological examinations, and physicians' work is relatively undervalued. A new healthcare policy (Moon Jae-In care) consists of the expansion of the National Health Insurance (NHI) coverage, reduction of patient charges for the vulnerable class, and support for catastrophic medical expenses. However, Moon Jae-In care is expected to negatively affect the NHI in Korea financially. The expansion of the insurance coverage for ultrasonography and MRI examinations is a significant part of the Moon Jae-In care, and radiological societies should establish fair compensations for physicians' work within the field of radiology while implementing the Moon Jae-In care.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.239-245
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• 2022

Purpose. The purpose of this study was to analyze the frequency and duration of adjustments after delivery of complete denture according to age, sex, arch with complete denture, insurance coverage of a denture, type of antagonist, the experience of wearing denture, the period of edentulism, and the type of denture base. Materials and methods. For 5 years, medical records of patients aged 65 or older who had treated full dentures were assessed for the frequency and duration of follow-up visits after complete denture delivery. Statistical analysis was performed at the 5% level of significance to analyze the correlation between the frequency and duration of follow-up according to sex, insurance coverage, arch with the complete denture, type of denture base, type of antagonist, experience of wearing a denture, age, and healing period. Results. 247 complete dentures were included in this study. The median frequency of follow-up visits was 3, and the median duration of follow-up was 36 days. Lower dentures had significantly higher frequency of follow-up visits than upper dentures (P = .036). According to the type of antagonist, dentures opposing a complete denture had a significantly higher frequency of follow-up visits than dentures opposing a removable partial denture (P = .016). There was no statistically significant difference in the frequency and duration of adjustments after delivery of complete denture by age, sex, insurance coverage, healing period, the experience of wearing a denture, and type of denture base. Conclusion. Within the limitations of the present study, lower complete dentures or dentures opposing a complete denture had an increased frequency of follow-up visits.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• The Journal of the Korea Contents Association
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• v.15 no.10
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• pp.374-386
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• 2015

This study attempts to examine the impact of a documentary film, on the perception and satisfaction with the public health insurance system in South Korea. It is needed that public support to expand health insurance coverage and to intensify national health insurance. The documentary film investigates health care in the United States, comparing with the non-profit universal health care systems of Canada, the United Kingdom, France and Cuba. So an online education content for the general education was developed using this film and the surveys were carried out to gather information about perception, satisfaction and opinion on national health insurance system before the lesson and after. And pared t tests were conducted to analyze the effects of this education content using the film on perception and attitudes towards national health insurance system. Based on the empirical results, the way to develop education contents for improving the understanding public health system and to verify the effect of education contents were discussed.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.85-91
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• 2016

Background: This study was conducted to determine the efficacy of staple line coverage using a polyglycolic acid patch and fibrin glue without pleural abrasion to prevent recurrent postoperative pneumothorax. Methods: A retrospective analysis was carried out of 116 operations performed between January 2011 and April 2013. During this period, staple lines were covered with a polyglycolic acid patch and fibrin glue in 58 cases (group A), while 58 cases underwent thoracoscopic bullectomy only (group B). Results: The median follow-up period was 33 months (range, 22 to 55 months). The duration of chest tube drainage was shorter in group A (group A $2.7{\pm}1.2day$ vs. group B $3.9{\pm}2.3day$, p=0.001). Prolonged postoperative air leakage occurred more frequently in group B than in group A (43% vs. 19%, p=0.005). The postoperative recurrence rate of pneumothorax was significantly lower in group A (8.6%) than in group B (24.1%) (p=0.043). The total cost of treatment during the follow-up period, including the cost for the treatment of postoperative recurrent pneumothorax, was not significantly different between the two groups (p=0.43). Conclusion: Without pleural abrasion, staple line coverage with a medium-sized polyglycolic acid patch and fibrin glue after thoracoscopic bullectomy for primary spontaneous pneumothorax is a useful technique that can reduce the duration of postoperative pleural drainage and the postoperative recurrence rate of pneumothorax.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.145-158
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• 2022

Objectives: To identify changes in the subjects and methods of Herbal Medicine Consumption Survey, and analyze trend of the key results Methods: The population, methods, and items of the basic reports of all Surveys on Consumption of Herbal Medicine(HM) were organized in a time-series manner. The analysis items were trend in the purchase of standardized HM; consumption value share, and price of prepared HM; type of herbal dispensary; and awareness of HM policy in Koran Medicine(KM) institutions. Results: The price of HM preparations showed an upward trend in 2011, 2014, and 2017 surveys, and decreased in the 2020 survey. However, despite this recent decrease, the 2021 survey also saw the highest proportion of HM users reporting that price of herbal decoction is expensive. Furthermore, the demand for expanded coverage of herbal decoction was the greatest for the expansion of health insurance benefits. Efforts such as adjusting the number of covered diseases and the cost of health insurance coverage would be necessary. Regarding decoction dispensaries the proportion of HM hospitals using only extramural herbal dispensaries increased. Finally, the consumption of HM and the size of the HM industry has continued to expand due to the large-scale branding of KM institutions and the expansion of health insurance coverage. Conclusion: Future surveys must standardize and unify the items for the time-series continuity and compare the results with government statistics reports on HM to increase reliability. Moreover, specialized survey items may be developed for KM, to establish a better and efficient distribution system for domestic HMs.

• The Journal of the Korea institute of electronic communication sciences
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• v.19 no.3
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• pp.577-582
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• 2024

In 2007, the first domestic pet insurance policies were introduced, and by 2023, numerous insurance products had been developed. The pet insurance market has been expanding steadily. However, as of 2022, only 0.8% of all pet owners have subscribed to pet insurance. Pet owners hesitate to enroll in pet insurance due to expensive premiums, unclear coverage details, and strict enrollment criteria. This paper proposes a model capable of detecting pet eye diseases and predicting their health age. Initially, EfficientNet is employed to identify the pet's eye disease, while OpenCV is utilized to locate and measure the size of the disease, enabling the calculation of the pet's healthy age. By leveraging the calculated health age, the aim is to aid insurance companies in determining pet insurance premiums. This model can facilitate the calculation of reasonable pet insurance rates based on the pet's eye condition and health age. Ultimately, the objective is to implement a system capable of detecting pet eye conditions and predicting their health age.

• KDI Journal of Economic Policy
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• v.12 no.3
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• pp.47-69
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• 1990

The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.