• 제목/요약/키워드: health insurance review department

검색결과 499건 처리시간 0.022초

우리나라 성인 2형 당뇨환자의 외래진료 지속성과 관련요인 분석 (Continuity of Ambulatory Care among Adult Patients with Type 2 Diabetes and Its Associated Factors in Korea)

  • 홍재석;김재용;강희정
    • 보건행정학회지
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    • 제19권2호
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    • pp.51-70
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    • 2009
  • Background : Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods : This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results : The continuity of care in the study population was $0.94{\pm}0.10$ as calculated by MMCI, $0.91{\pm}0.16$ as calculated by MFPC and $0.86{\pm}0.23$ as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion : The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients' characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.

신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향 (The Effect of Reform of New Diagnosis-Related Groups on Coverage of National Health Insurance)

  • 최정규;김선희;장정하;윤종민;강중구
    • 보건행정학회지
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    • 제30권2호
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    • pp.178-184
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    • 2020
  • Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

혀에 발생한 신경초종 1예 및 고찰 (Schwannoma of Tongue : A Case Report and Review)

  • 이원일;김홍준;서영준;노경진;최은창;홍현준
    • 대한두경부종양학회지
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    • 제26권2호
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    • pp.228-231
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    • 2010
  • Schwannoma is a relatively uncommon, slow-growing benign tumor that is derived apparently from the Schwann cell. Tongue originated schwannomas are exceedingly rare within 1% and therefore often are not immediately included in the differential diagnosis and oral cavity tumors. In the current study, authors report a case of a schwannoma located at the tongue of a 49 years old patient treated by complete surgical excision. The patient is under clinical control, with no signs of recurrence even after 6 months.

Building Linked Big Data for Stroke in Korea: Linkage of Stroke Registry and National Health Insurance Claims Data

  • Kim, Tae Jung;Lee, Ji Sung;Kim, Ji-Woo;Oh, Mi Sun;Mo, Heejung;Lee, Chan-Hyuk;Jeong, Han-Young;Jung, Keun-Hwa;Lim, Jae-Sung;Ko, Sang-Bae;Yu, Kyung-Ho;Lee, Byung-Chul;Yoon, Byung-Woo
    • Journal of Korean Medical Science
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    • 제33권53호
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    • pp.343.1-343.8
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    • 2018
  • Background: Linkage of public healthcare data is useful in stroke research because patients may visit different sectors of the health system before, during, and after stroke. Therefore, we aimed to establish high-quality big data on stroke in Korea by linking acute stroke registry and national health claim databases. Methods: Acute stroke patients (n = 65,311) with claim data suitable for linkage were included in the Clinical Research Center for Stroke (CRCS) registry during 2006-2014. We linked the CRCS registry with national health claim databases in the Health Insurance Review and Assessment Service (HIRA). Linkage was performed using 6 common variables: birth date, gender, provider identification, receiving year and number, and statement serial number in the benefit claim statement. For matched records, linkage accuracy was evaluated using differences between hospital visiting date in the CRCS registry and the commencement date for health insurance care in HIRA. Results: Of 65,311 CRCS cases, 64,634 were matched to HIRA cases (match rate, 99.0%). The proportion of true matches was 94.4% (n = 61,017) in the matched data. Among true matches (mean age 66.4 years; men 58.4%), the median National Institutes of Health Stroke Scale score was 3 (interquartile range 1-7). When comparing baseline characteristics between true matches and false matches, no substantial difference was observed for any variable. Conclusion: We could establish big data on stroke by linking CRCS registry and HIRA records, using claims data without personal identifiers. We plan to conduct national stroke research and improve stroke care using the linked big database.

설하신경 기원의 신경초종 1례 (A Case of Schwannoma Originated from Hypoglossal Nerve)

  • 양해동;강주완;김성수;진윤미
    • 대한두경부종양학회지
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    • 제18권2호
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    • pp.207-210
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    • 2002
  • Schwannoma is a relatively rare benign tumor which may occur from nerve sheath of the peripheral, sympathetic and cranial nerves and so on except optic and olfactory nerves which have no nerve sheath themselves. Although it occur most frequently in the head and neck region especially in the acoustic nerve, the schwannoma originated from the motor nerves including hypoglossal nerve is very rare. Recently, we have experienced a case of schwannoma originated from hypoglossal nerve in a 47-year-old female. We report this case with literature review.

혀에 국한하여 발생한 대칭성 지방종증 1예 (A Case of Symmetrical Lipomatosis Limited of the Tongue)

  • 정세원;남재성;기정혜;신향애
    • 대한두경부종양학회지
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    • 제31권2호
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    • pp.58-62
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    • 2015
  • Benign symmetric lipomatosis, also known as Madelung's disease, Launois-Bensaude syndrome and multiple symmetric lipomatosis is a cutaneous condition characterized by extensive symmetric fat deposits in the neck, shoulders, and upper trunk. But symmetrical lipomatosis of the tongue is very rare and characterized by involvement exclusively of the tongue, invasiveness, and absence of encapsulation of the adipose tissue. A 75-year-old man presented with about a year history of painless tongue masses on both lateral border. Bilateral partial glossectomy was performed and subsequently was confirmed as symmetrical lipomatosis pathologically. We report this case with a review of the literatures.

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하인두에 발생한 지방육종 1예 (A Case of Hypopharyngeal Liposarcoma)

  • 양해동;김현직;김성헌;이원애
    • 대한두경부종양학회지
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    • 제19권1호
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    • pp.71-74
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    • 2003
  • Liposarcoma is one of the most common malignancies originating from human soft tissue. Because most of liposarcoma occur in the lower extremities or retroperitoneum, there are few reports about liposarcoma of head and neck region, including larynx and pharynx. Histologically, there are four types of liposarcoma, and prognosis and recurrence rate are different according to histologic subtype. Wide excision is the treatment of choice and liposarcoma hardly respond to primary radiotherapy. A 56-year-old man presented with voice change and foreign body sensation in laryngopharynx. Hypopharyngeal liposarcoma was diagnosed by surgical biopsy and performed totallaryngopharyngoesophagectomy and gastric pull-up. Here we report our experience on this case with review of literature.

설배부에 발생한 국한성 혈관각화종 1예 (A Case of Angiokeratoma Circumscriptum of the Dorsal Tongue)

  • 남재성;홍창의;김의정;신향애
    • 대한두경부종양학회지
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    • 제32권2호
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    • pp.47-50
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    • 2016
  • Angiokeratomas represent vascular lesions and are histologically characterized by superficial dermal vascular ectasia with overlying epidermal hyperkeratosis. Angiokeratoma circumscriptum is one of five types in the group of the angiokeratomas. The lesion is present from birth but may appear in childhood or adulthood. Angiokeratoma circumscriptum is typically hyperkeratotic papules or nodules situated unilaterally on the foot or distal aspect of the leg, but can occur elsewhere on the body. Isolated tongue involvement is very rare. We report a 12-year-old boy with angiokeratoma circumscriptum of the posterior dorsal tongue with a review of the literatures.

경부에 발생한 점액성 지방육종 1예 (A Case of Myxoid Liposarcoma of Neck)

  • 이규인;기정혜;신향애;김지훈
    • 대한두경부종양학회지
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    • 제37권2호
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    • pp.71-75
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    • 2021
  • Liposarcoma is a very rare malignant tumor affecting the head and neck area. Since it is an invasive and life-threatening disease, active treatments is necessary. However, differential it from lipoma, its corresponding benign counterpart, may be difficult. Herein, we report a rare case of posterior neck myxoid liposarcoma in a 72-year-old man who was initially misdiagnosed with lipoma, including a literature review of differential diagnosis between lipoma and liposarcoma.