• Journal of Periodontal and Implant Science
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• 제49권4호
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• pp.248-257
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• 2019

Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

• 보건행정학회지
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• 제32권2호
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• pp.137-153
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• 2022

In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

• 보건행정학회지
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• 제28권3호
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• pp.210-216
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• 2018

National Health Insurance Service (NHIS) has put a great effort on extending life expectancy, for last 40 years. The system has also made remarkable outcomes in achieving universal health coverage. However, it is facing challenges of low health insurance benefits and sustainability risk due to low birth rate and aging society at the same time. To overcome the difficulties and build a lifelong health security system for the nation, it is required for NHIS to make multilateral changes in its roles. Based on the quantitative growth achieved so far, NHIS needs to strive for the growth in quality by not only increasing coverage and reforming contribution imposition system, but also reorganizing the relevant systems such as lifelong health management support, rational adjustment to the medical fee, and benefit costs monitoring. In addition, it's important for NHIS to restructure the organizational culture by having specialty and communicating with people for high quality of administration and health insurance sustainability.

• 한국치위생학회지
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• 제12권4호
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• pp.751-758
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• 2012

Objectives : This study aimed to seek the national health insurance coverage and the efficient direction of toothbrushing instruction and to contribute to establishing policy as auxiliary data, targeting 373 dental hygienists who are working in some areas of Jeonnam. Methods : A research method was questionnaire survey by individually self-administration method. Results : It was indicated to agree to the national health insurance coverage of toothbrushing instruction in the better understanding and cooperation level with toothbrushing instruction, in case of carrying out toothbrushing instruction, and in the higher age group. Conclusions : There will be a need of allowing the national health insurance coverage to be formed in the direction at which the dental service providers and the dental service consumers can be satisfied, by being performed a comprehensive and sufficient research for this.

• 한국치위생학회지
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• 제16권2호
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• pp.195-204
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• 2016

Objectives: The purpose of the study is to investigate the knowledge, attitude, and recognition of health insurance coverage in tooth implant among Korean adults. Methods: A self-reported questionnaire was completed by 420 adults over 20 years lod in Seoul and Gyeonggido from October 1 to December 15, 2014. The questionnaire consisted of general characteristics of the subjects, knowledge, attitude, and recognition of health insurance coverage in tooth implant. Results: The mean of knowledge of regular checkup after implant was 3.05 points, and mean of advantage and disadvantage of implant was 3.03 points. The expectation for the implant treatment was 4.18 points and this was the highest score. There was no significant difference between the knowledge and attitude in age and monthly compensation(p>0.05). Only 45.6% of the adults were aware of the health insurance coverage of tooth implant since July, 2014. Health Insurance meeds to be modified in the beneficiaries age(44.6%), and cost(32.7%). The positive aspects of implant care included medical expenses(37.8%), health care beneficiary(29.1%), and oral health promotion(20.9%). Conclusions: Health insurance coverage of tooth implant is very important to enhance the quality of life in the adults because the proper management and implementation of the health insurance in implant will improve the oral health care in life.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2259-2263
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• 2013

Background: Public use National Health and Nutrition Examination Survey (NHANES III) and NHANES III linked mortality data were here applied to investigate the association between health insurance coverage and all cause and all cancer mortality in adults. Patients and Methods: NHANES III household adult, laboratory and mortality data were merged. Only patients examined in the mobile examination center (MEC) were included in this study. The sampling weight employed was WTPFEX6, SDPPSU6 being used for the probability sampling unit and SDPSTRA6 to designate the strata for the survey analysis. All cause and all cancer mortalities were used as binary outcomes. The effect of health insurance coverage status on all cause and all cancer mortalities were analyzed with potential socioeconomic, behavioral and health status confounders. Results: There were 2398 sample persons included in this study. The mean age was 40 years and the mean (S.E.) follow up was 171.85 (3.12) person months from the MEC examination. For all cause mortality, the odds ratios (significant p-values) of the covariates were: age, 1.0095 (0.000); no health insurance coverage (using subjects with health insurance), 1.71 (0.092); black race (using non-Hispanic white subjects as the reference group) 1.43, (0.083); Mexican-Americans, 0.60 (0.089); DMPPIR, 0.82, (0.000); and drinking hard liquor, 1.014 (0.007). For all cancer mortality, the odds ratio (significant p-values) of the covariates were: age, 1.0072 (0.00); no health insurance coverage, using with health coverage as the reference group, 2.91 (0.002); black race, using non-Hispanic whites as the reference group, 1.64 (0.047); Mexican Americans, 0.33 (0.008) and smoking, 1.017 (0.118). Conclusion: There was a 70% increase in risk of all cause death and almost 300% of all cancer death for people without any health insurance coverage.

• 의료법학
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• 제8권2호
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• pp.37-68
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• 2007

Health insurance has gone far toward solving Korea's health related problems through thirty years. Health Insurance as social security system has a role of national system to secure national health. But there are many problems in health insurance. There is a dispute about many issues, coverage of health security, compulsory appointment of health insurance organization, coverage and level of health insurance benefit, decisionmaking right of health insurance price, examination of health insurance etc. Generally, the opinion for health insurance policy to be leaded by nation sets against the opinion to be leaded by private sector. It is necessary to study politics of law, constitute law and comparative law for rational solving these problems. If desirable setting of health law system can be made, legal system must be set during a long time and be discussed synthetically in different standpoint.

• 한국치위생학회지
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• 제15권1호
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• pp.31-38
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• 2015

Objectives: The purpose of this study is to investigate the factors of oral health beliefs on scaling performance by national health insurance coverage in consumers. Methods: The subjects were 353 people living in Seoul, Incheon, and Gyeonggi-do from September 25 to October 20, 2013. They filled out the self-reported questionnaire after receiving informed consents. The questionnaire included 6 questions of general characteristics, 6 questions of oral health behavior, 6 questions of health insurance coverage, and 1 question of subjective oral health recognition. The oral health belief consisted of 6 questions of seriousness, 6 questions of susceptibility, 8 questions of barriers, 5 questions of benefit, and 3 questions of self-efficacy measure by Likert 5 scale. Cronbach's alpha in the study was 0.759. Data were analyzed using SPSS version 20.0 for frequency analysis, t-test, ANOVA, post-hoc Scheffe test, Pearson's correlation coefficient, and binary logistic regression. Results: The influencing factors of oral health belief model were Seriousness(${\beta}=0.091$), Self efficacy(${\beta}=-0.471$) and age(${\beta}=0.855$)(p<0.05). Those who had highly perceived seriousness and younger age tended to have probability of scaling performance. Higher self-efficacy tended to take more chance to have scaling performance probability. Conclusions: In order to cover the scaling by national health insurance, it is very important to notice the benefit of health insurance coverage of scaling to the consumers. National health insurance coverage enables the scaling practice to be easily accessible to the people. Easy access to scaling by low cost strategy can improve the oral health behavior.

• 한국융합학회논문지
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• 제9권2호
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• pp.125-136
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• 2018

본 연구는 의료소비자를 대상으로 실시되고 있는 치과건강보험급여화의 인식도를 조사하여 미래 치석제거 국민들의 구강건강향상을 위해 치과건강보험급여가 확대되고자 하는데 목적이 있다. 연 1회 치석제거급여 연령에 대한 적절성 여부는 나이와 교육수준에서 유의한 차이가 있었고(p<0.05), 연 1회 치석제거 급여횟수에 대한 적절성 여부는 결혼여부, 지역(구), 자가구강건강인지에서 유의하였으며(p<0.05), 연 1회 치석제거 급여수가에 대한 적절성 여부에서는 하루잇솔질총횟수가 통계적으로 유의하였다(p<0.05). 결국 연령이 증가하면서 나타나는 치주질환의 증가로 국가 차원에서의 건강보험급여 항목이 추가되어야 하며, 본 연구결과에서와 같이 치석제거 건강보험급여화는 연령, 횟수, 수가부분에서 더욱 확대 되어야하며, 향후 치과건강보험 급여정책 향상을 위한 노력은 국민의 구강건강을 위해 계속되어야 한다.

• 대한예방한의학회지
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• 제23권3호
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• pp.109-119
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• 2019

Background : Germany is the first country in the world to introduce modern systems of public health insurance, and the country which most widely uses complementary alternative medicine(CAM) in Europe. In early 21^st century, a large evaluation studies were conducted to include acupuncture in health insurance payments, which were eventually decided. Objectives : This study is to investigate and analyze the process of public policy determination on insurance coverage for acupuncture in German health insurance system. Methods : We collected the data and information through the literature search and from the websites of German government departments and health insurance organizations. To obtain contextual information, German experts of health insurance and acupuncture clinical study were interviewed. Results : As use of acupuncture had been growing, German public health insurers wanted to evaluate the validity of acupuncture coverage and sponsored three evaluation projects for clinical effectiveness of acupuncture using randomized clinical trials, systematic reviews, and pragmatic trials from 2001 to 2005. For some pain condition, acupuncture was founded not to be effective than sham acupuncture, but more effective than standard care. The federal joint committee of health insurance decided to cover acupuncture for chronic pain of lumbar spine and chronic pain in at least one knee joint due to gonarthrosis. Conclusions : Considering the controversial subject matter in the process of acupuncture's health insurance coverage in Germany, expanding the benefits of Korean medicine in Korea needs to come up with ways to overcome the difficulties of placebo effect, standardization and lack of literature evidence.