• 보건행정학회지
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• 제22권1호
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• pp.145-162
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• 2012

The purpose of this study is to understand magnitude and its related factors of user's cost-sharing for non-covered services in long-term care facilities. We corrected data for 1,016 subjects, based on the long-term care benefits cost specification. Eighteen subjects were excluded from the data analysis due to missing data on family care-givers characteristics. Finally, 998 subjects were included in the study. The average cost of non-covered services per month was 209,093 won and distributed from 0 to 1,011,490 won. There was a significant difference by the characteristics of family care-givers and long-term care facilities. The monthly average cost for meal materials per person was 199,181 won(0~558,000), average cost of additional charge caused by using private bed was 232,992 won (50,000~600,000), and costs for haircut and cosmetics were 8,599 won. For the rest, there were various programs costs(93,328 won), diaper and its disposal cost(109,628 won), purchase cost for daily necessaries(24,435 won) and etc. The related factors for the magnitude of non-covered services expenditures were education level of family care-givers, occupancy rate and location of LTC facilities, and the costs of using private bed, haircut and cosmetics, and various programs among non-covered services. These findings suggest that present level range of LTC facilities users' cost-sharing is wide and it is urgent to prepare the standard guideline for cost and level in non-covered services.

• 한국병원경영학회지
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• 제24권3호
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• 보건의료산업학회지
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• 제11권1호
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• pp.43-53
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• 2017

Objectives : In this paper, we proposed a method to comprehensively examine the roles of medical insurance review nurses' by analyses of task importance and task performance. Methods : For the analyses, we used the responsesof 268 nurses who completed a questionnaire for members of the Medical Insurance Review Nurses Association in 2015, and analyzed task importance and task performance using the IPA method and the standard task guide. Results : There were significant differences in task importance and task performance according to task position. In the category of 'Keep up the good work,' 'Calculate benefit standard' was indicated only in administrative positions, and in the category of 'Concentrate here,' 'Manage hospital resources' and 'Process after appeal results' was demonstrated only in general positions. There were differences in the 'Low priority' and 'Possible overkill' categories by task performance according to task position. Conclusions : Our results indicate the necessity of a new education system and task reassignment according to task importance and task performance as perceived by medical insurance review nurses.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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• pp.221-225
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• 2017

Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

• 보건교육건강증진학회지
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• 제27권4호
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• pp.91-103
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• 2010

Objectives: This study was designed to understand the association between sociodemographic characteristics, health behaviors and channels retrieved for health information. Methods: Questionnaire survey was performed from April 2007 to May 2007 through household visiting. Sample was selected according to gender, household income, and residence district. We got 1,009 respondents and subgroups were as follows; 508 people had health insurance, 250 people were medical indigent group, and 251 people were medicaid beneficiaries. Results: People seemed to be separated into subgroups by channels used for health information. One was active and the other was passive group. Characteristics of passive group were older age, worker or inoccupation, less income, subjective poverty, lower education, loss of spouse, medical indigent or medicaid group. They usually got health information through mass media like TV and radio or medical professionals. Characteristics of active group were younger age, professional, more income, subjective affluence, higher education, single or married, and member of health insurance. They mainly got health information through printed media like newspaper or the Internet. Conclusion: We suggest to provide health information through various channels customed to individual needs and literacy. Public health stakeholders seems better to focus on people with low education, insufficient health literacy, poor health status, and short information technology.

• 한국수학교육학회지시리즈E:수학교육논문집
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• 제19권4호
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• pp.683-698
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• 2005

The volume of insurance business of Korea is now ranked 6th in the world. In spite of the rapid growth of the volume of the Korean insurance market, the growth of quality and technology of Korean insurance business has not reached on the top position. And the role of actuaries in Korea does not come up to the standard of the advanced economies due to the total lack of good actuarial science programs in Korea. In this paper, we consider a few desirable actuarial science programs for both undergraduate and graduate level and show concrete examples of curriculums useful in Korean universities. The curriculums are designed to help students to pass the four exams of Society of Actuaries and Casualty Actuarial Society and to get credits for Validation by Educational Experience (VEE). At the same time our curriculums can cover the contents of Korean actuarial exams. We also consider the actuarial internship programs.

• 보건교육건강증진학회지
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• 제32권3호
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• pp.97-107
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• 2015

Objectives: The current study aims to examine whether the influence of National Long-term Care Insurance(NLCI) on the quality of life(QoL) trajectory of older adults with disabilities is more positive than its influence on those without disabilities. Methods: Sample consisted of 5,362 elderly aged 65 and over who participated in the Korean Welfare Panel Study from Wave1 to Wave7. Data were analyzed using latent growth curve modeling. Results: Major findings are as follows. (1) Before the NLCI, the trajectories of QoL between older adults with disabilities and those without were same. (2) After the NLCI, elders with disabilities showed lower levels of QoL at the beginning, but the gaps gradually decreased with time. These results indicate that the implementation of NLCI more positively affected elders with disabilities than those without disabilities. Conclusions: These results suggest that the NLCI functions properly as one of social security nets to cope with the needs of older adults with disabilities. In conclusion, it is critical to develop a sustainable NLCI system to enhance the QoL of older adults with disabilities.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.23-35
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• 2010

Purpose: The purpose of this paper is to analyze the demand and supply of advanced practice nurses and suggest alternative benefit strategies in the Korean national health insurance. Methods: A revised demand & supply model was used to estimate the excess supply of APNs, and policy making process and key actors in the Korean health insurance were considered to develop a political approach to the APN issue. Results: The social demand for APNs is currently estimated to be less than 50% of its supply and the APN education program fell into difficulties in recruits. No reimbursement mechanism for APN's services in the national health insurance has given no economic incentive to hospital managers who have monopsony power in nursing labor market, which has caused the demand shortage of APNs in hospital industry. Payment for APN's services recognized as one of the most significant strategies to booster the social demand for APN's services should be carefully designed and implemented in the national health insurance. In line with this, key actors in health insurance policy decision-making include government, national assembly, labor unions, NGOs, civic groups, medical associations, and academia. Conclusion: The basic researches for APN's activities and cost-effectiveness analysis in clinical settings are required to support the strategies aforementioned. Constructing a policy network among key actors is able to make the payment strategy feasible, which will increase the socal demand for APNs.

• 정신신체의학
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• 제25권1호
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• pp.56-62
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• 2017

Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

• 한국콘텐츠학회논문지
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• 제18권9호
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• pp.454-467
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• 2018

본 연구에서는 보험소비자의 권리의식과 책임의식의 수준이 어떠한지 살펴보고, 권리 및 책임의식 수준에 따라 소비자를 유형화하여 유형별 의사결정 행동에 어떠한 차이가 있는지를 실증적으로 분석하였다. 이를 위해 생명보험협회의 '생명보험업의 민원발생유형 분석 및 소비자보호 강화방안'의 총 1,225명 데이터를 활용하여 확인적요인분석, 신뢰도분석, 대응표본 t-test, 교차분석 및 분산분석을 시행하였다. 연구결과 보험소비자의 책임의식은 권리의식과 비교했을 때 비교적 낮은 수준이었고, 권리의식에 상응하는 책임의식이 갖추어진 소비자집단이 더욱 합리적이고 주체적인 의사결정을 내리고 있음을 확인할 수 있었다. 이러한 결과를 바탕으로 보험소비자의 바람직하고 주체적인 의사결정을 위해서는 권리의식에 상응하는 책임의식을 강조하는 소비자교육이 필요함을 확인하였다. 본 연구는 소비자문제를 해결할 수 있는 보험소비자의 권리 및 책임의식의 제고를 위한 콘텐츠개발의 기초자료를 제공한다는 점에서 의의가 있다. 특히 금융소비자의 권리의식과 책임의식에 관한 연구가 다각도로 이루어지지 않은 상황에서, 권리의식만큼이나 책임의식이 중요하다는 것을 학술적으로 밝혔다는 점에서 더욱 의의가 있다고 할 수 있다.