• Journal of Digital Convergence
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• v.17 no.5
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• pp.77-88
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• 2019

This study is empirically intended to look into the effects of basic income security on poverty elimination and life independence in income security policies. To achieve this, poverty elimination and life independence through the national pension and basic pension as old-age pension for basic income security and the unemployment benefit and livelihood benefit as employment insurance were determined as dependent variables. The 10th data from Korea Welfare Panel Study were used in the statistical package program to analyze these variables. The overall findings showed that the national pension and basic pension as part of the old-age pension had a positive effect on poverty elimination and life independence. The unemployment benefit and livelihood benefit of employment insurance were not significant and they were rejected. And poverty elimination had a significant effect on life independence and it was adopted. Consequently, the old-age pension is a pensionable income security policy given to all the elderly with lower income, which it is very useful for guaranteeing a basic income. Poverty elimination leads to life independence through the guarantee of a certain basic income, suggesting that they are closely related to each other.

• Journal of agricultural medicine and community health
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• v.16 no.2
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• The Journal of the Korean life insurance medical association
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• v.27 no.1
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• pp.33-36
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• 2008

BACKGROUND : The medical claims review(MCR) is unique methodology of medical consultation in terms of insurance claim administration in Korean insurance market. The most important practical matter in the MCR is formatted question. In Korea, medical specialty is composed of 26 legally defined hospital departments. It is worth of studying to investigate type of MCR by hospital departments. METHODS : Fifty Cases of the MCR were selected randomly by statistical program SPSS among 1,032 cases which were performed between April 1, 2006 and March 31 2007. All of selected cases were evaluated one insurance doctor and made a score points from 0 to 10 in terms of hospital department. RESULTS : Multidimensional scaling was performed. The MCR types - diagnosis, malignancy and cause of death are located in the same 2-dimensional configuration area. It can be called as verification of benefit. Others are advice. - such as causality, interpretation, translation, independent medical examination, and so on. DISCUSSION : We can conclude the classification of MCR typology are two main subjects, verification and advice. Theses results are same as previous article which was based on experience.

• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.362-373
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• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.3
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• pp.29-42
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• 2017

Background : Efforts towards increasing insurance coverage for traditional Korean medicine (TKM) are being continued. However, various difficulties are faced in generating evidence for TKM due to limited financial support and the low quality of research methodology. Objectives : The objectives of this study were to review the Swiss evaluation program for complementary and alternative medicine (CAM) and assess the expansion in public health insurance coverage of complementary medicine as approved by referendum in Switzerland. Methods : The regulations of CAM in the European Union were assessed. Research articles, reports, government publications and websites which deal with the 'Programm Evaluation $Komplement{\ddot{a}}rmedizin$ (PEK)' and the referendum in Switzerland were searched for and analyzed. Results : The PEK was conducted from 1998 to 2005. The PEK evaluated the efficacy, utilization and cost-effectiveness of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine. However, clear conclusions could not be drawn from the evaluation according to the PEK Report. Later, a referendum was implemented in which 5 therapies would be added to the Switzerland Constitution with the support of the public. The coverage of CAM was approved by Swiss a plebiscite with an approval rate of 67.0%. Conclusions : The reason for the successful referendum is suggested to be public support and the solidarity with CAM experts and politicians. It may be surmised that recognition of the political efforts and scientific aspects required to expand insurance coverage of TKM, and towards obtaining public support, is necessary.

• Journal of dental hygiene science
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• v.16 no.3
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• pp.249-255
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• 2016

The Ministry of Health and Welfare in Korea has enforced the oral health promotion program for elderly in Korea. There are the denture delivery program and the fluoride application-scaling program for elderly. Donggu Public Health Center in Daejeon has delivered the fluoride application-scaling program for elderly since the demonstration project in 2009. The official dental hygienists had a prior consultation with Dong-gu branch of Korean Senior Citizens Association in Daejeon. We expanded the program through government office, welfare centers, and nursing homes. The participants were satisfied with the public relations (95.2%), scaling (99.7%), fluoride application (91.5%), toothbrushing education (98.6%), and denture cleaning education (96.6%). After a medial accident with persistent bleeding, the pre-inspection survey about systemic disease and medication was reinforced. The official dental hygienists have agonized over the low participation of the low-income group and the overlap benefit with health insurance benefit of scaling. We suggested it be needed the assessment of the public oral health program to overlap with health insurance benefit.

• Journal of Digital Convergence
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• v.11 no.3
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• pp.1-12
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• 2013

Present study examines the gender disparity in terms of its beneficiaries or benefit amount of National Pension of South Korea from the perspective of gender sensitivity. National Pension system has been manipulated and developed in order to maximize its universality. However, substantial gender differences are still found in terms of beneficiary number and benefit amount in the program. Benefit condition and benefit structure are determined assuming that male is the primary breadwinner in household and the primary regular full time worker in labor market. Women are only counted as dependents or excluded as unstable workers. As a result, women are fully or partially excluded from the program as they are excluded in other public sector such as labor market. Women's work (such as caring and housekeeping) are not taken into account in National Pension program. Policy suggestions for the National Pension of South Korea are also provided as the last part of this paper.

• Journal of radiological science and technology
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• v.44 no.5
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• pp.495-502
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• 2021

This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.

• Health Policy and Management
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• v.24 no.3
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Journal of Korean society of Dental Hygiene
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• v.12 no.5
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• pp.999-1006
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• 2012

Objectives : The purpose of this study was to understand and compare the knowledge of the adolescents and adults among the residents of Seoul metropolitan city about water fluoridation program. Methods : A total of 613 adolescents and adults between the age of 15 and 31-49 was surveyed by the questionnaire. Among them, the source of drinking water, the source of cooking water, awareness of caries prevention effect of water fluoridation program, awareness of cost benefit of health insurance of water fluoridation program, approval of water fluoridation program, awareness of health safety of water fluoridation program were surveyed. Results : 85.5% of adolescents and 88.9% of adults were surveyed to use public water supply for drinking water, and 95.3% of adolescents and 96.8% of adults were surveyed to use public water supply for cooking water. But only 14.0% of adolescents, comparing to the 42.1% of adults, were surveyed to be aware of the caries prevention effect of water fluoridation, and only 6.0% of adolescents, comparing to the 24.6% of adults, were surveyed to be aware of the caries prevention effect of water fluoridation to reduce to health insurance expenditure. About 82.6% of adolescents, comparing to the 92.1% of adults, were surveyed to vote for the fluoridation program, and only 6.8% of adolescents, comparing to the 28.6% of adults, were surveyed to be aware of health safety of water fluoridation program. Conclusions : Extensive oral health education program to the adolescents are necessary about using water fluoridation to prevent the dental caries.