• Title/Summary/Keyword: insurance price

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A study on appropriateness of price of medical care service in health insurance (의료보험서비스 가격의 적절성에 관한 연구 : 소득계층간 접근형평성 관점에서)

  • Chun, Ki-Hong;Choi, Kui-Son;Kang, Im-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.460-470
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    • 1998
  • By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

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Approach to History and Problems of Health Insurance through Politics of Law (국민건강보험법의 발전과정과 법정책적 과제)

  • Cho, Hyong-Won
    • The Korean Society of Law and Medicine
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    • v.8 no.2
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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.

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Recognition and adequacy of dental service providers regarding dental prosthesis covered by dental auto insurance system (치과자동차보험 보철수가제도에 관한 치과 의료공급자의 인식도 및 적정성 방안에 관한 연구)

  • Sim, Sungho;Chun, Sung-Soo;Yun, Mi Eun
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.4
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    • pp.531-538
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    • 2016
  • Objectives: The purpose of the study is to investigate recognition and adequacy of dental service providers regarding dental prosthodontic treatment covered by dental auto insurance system. Methods: A self-reported questionnaire was completed by 320 dentists and dental hygienists in Seoul, Gyeonggido, and Incheon from February 22 to March 21, 2016. The questionnaire consisted of recognition and needs of auto insurance (4 items), and recognition of prosthodontic treatment covered by dental auto insurance system. Likert five point scale was used in the questionnaire. Data were analyzed by SPSS 21.0 program. Cronbach's alpha was 0.856 in the study. Results: The average of recognition was 2.62 and that of adequacy of auto insurance coverage was 1.98. The reasonable price of crown treatment was from 400,000 to 500,000 Korean Won in 67.9 percent of the dentists. But 49.8 percent of the dental hygienists answered that the reasonable price of crown was 300,000 to 400,000 Korean Won. The dentists preferred to treatment fee covered by dental auto insurance. The dental hygienists had a preference to combination of dental auto insurance and medical insurance fee. Conclusions: The opinion of the dental care providers should be considered and the adequate coverage of insurance would improve the dental health care.

A Study for The Pharmaceutical Pricing Standard of the National Health Insurance in Japan (일본의 건강보험 약가 산정기준에 관한 연구)

  • Ryu, Chung-Kul
    • Korea Journal of Hospital Management
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    • v.14 no.4
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    • pp.52-70
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    • 2009
  • This study is to analyse the reimbursement prices of drugs in Japan. Japan has the world's second-largest pharmaceutical market, and the world's largest price-controlled pharmaceutical market. The reimbursement prices of new drugs in Japan are determined by confidential negotiations between the manufacturer and the Japanese Ministry of Health, Labor, and Welfare. Pharmaceuticals account for a larger share of total healthcare expenditures in Japan than in most other major pharmaceutical markets such as France, Germany, United Kingdom and United States. Prescription drugs' share of total healthcare spending has slightly increased in recent years, from 20.2% in 2000 to 21.5% in 2004, the most recent year for which data are currently available. This trend is attributable to the effect of the Japanese rapidly aging population that stimulates demand for healthcare services. There are several method of price setting for drugs as below. First, on the initial pricing of branded drugs, is the similar-efficacy pricing method and cost calculation method. Second is postmarketing price changes which are biennial price revisions under the rule of National Health Insurance. Third is the rule of the generics price. Recently, the generics market is expanded because there are increasing numbers of hospitals by DPCs(Diagnosis-procedure Combinations).

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Estimating the Reimbursing Price Level of Oriental Medical Services in the National Health Insurance (한방의료서비스의 건강보험수가 산출방법과 추정)

  • Kim, Jin-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.3
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    • pp.21-34
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    • 2008
  • Objectives : This paper analysed the alternative methods of calculating conversion factor for oriental medicine in the National Health Insurance and estimated the conversion factor(reimbursing price level) of the oriental medical services, based on health insurance claims data and macro economic data. Methods : Comparing cost accounting method, SGR model, and index model to estimate conversion factor in the national health insurance, six empirical models were derived depending on the scope of revenue considered in financial indicators. Classifications of data and sources used in the analysis were identified as officially released by the government. Results and Conclusion : Cost accounting analysis and SGR model showed a two digit decrease in the physician fee schedule of oriental medical services in the national health insurance, while index model indicated a positive increase in the fee reimbursed. As expected, SGR model measured an overall trend of health expenditures rather than an individual financial status of medical institutions, and index model properly estimated the level of payments to oriental medical doctors. Upon a declining share of health expenditures on oriental medicine, a global budget system fixed to a flat rate of total budget could be an opportunity as well as a challenge.

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New Drug Listing Process and Reimbursement Standard Management (약제의 신규등재 절차와 급여기준 관리)

  • Yoon Kyeong Bai;Mi-Young You
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.104-107
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    • 2023
  • The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

A Study on the Macroeconomic Effects of Trade Insurance Using Dynamic Panel Models (동태적 패널모형을 통한 무역보험의 거시경제효과 연구)

  • Nam, Sang Wook
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.61
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    • pp.165-190
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    • 2014
  • The purpose of this study is to measure the trade insurance's macroeconomic effects by analyzing the causality between major economic variables(GDP per capita, market interest rate, inflation, unemployment rate, exchange rate) and trade insurance variable. I conducted empirical analyses using First-difference GMM(Generalized Method of Moments), System GMM and Panel-VAR Model, with panel data from 11 countries(Korea, United States, Japan, BRICs, Indonesia, Singapore, Hong Kong, Vietnam) between 1992 and 2011. There are several important findings. Above all, Trade insurance is positively and significantly related to GDP. This results show that trade insurance serves to increase economic growth. In other words, trade insurance leads to economic growth by helping increase GDP per capita. Especially, trade insurance negatively related to unemployment rate, it is for sure that trade insurance contribute to decrease unemployment rate. And trade insurance helps control of inflation. It is also confirmed that trade insurance contributes to price stability, which in turn serves to stabilize the overall economy. And this research finds as uncertainty in the market increases, seen it as increase of exchange rate, increasing trade insurance supply is stabilize the exchange rate.

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AN APPROXIMATED EUROPEAN OPTION PRICE UNDER STOCHASTIC ELASTICITY OF VARIANCE USING MELLIN TRANSFORMS

  • Kim, So-Yeun;Yoon, Ji-Hun
    • East Asian mathematical journal
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    • v.34 no.3
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    • pp.239-248
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    • 2018
  • In this paper, we derive a closed-form formula of a second-order approximation for a European corrected option price under stochastic elasticity of variance model mentioned in Kim et al. (2014) [1] [J.-H. Kim, J Lee, S.-P. Zhu, S.-H. Yu, A multiscale correction to the Black-Scholes formula, Appl. Stoch. Model. Bus. 30 (2014)]. To find the explicit-form correction to the option price, we use Mellin transform approaches.

A Study on the Effect of Chonsei Price Increase on the Index of Financial Industry (전세가격상승이 금융산업 생산지수에 미치는 영향에 관한 연구)

  • Jo, I-Un;Kim, Bo-Young
    • The Journal of the Korea Contents Association
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    • v.15 no.10
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    • pp.457-467
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    • 2015
  • Despite the recent phenomena of Chonsei price increase, low interest rate and low growth, the indexes of financial and insurance industry production showed the results contrary to the common belief that the financial industry is sensitive to such financial crises. This is because the index of financial industry has continuously maintained a certain level of increase as opposed to the index of all industry production. Thus, this study aimed to analyze the dynamic correlation between the index of financial industry production and Chonsei price increase. A vector autoregression (VAR) model, which doesn't have a cointegrating relationship, was used to define the Chonsei price index and the indexes of all industry production and financial and insurance industry, which are macro economic variables, and describe the data. The results of the analysis on the time series data of 183 months from January 2000 to May 2015 showed that Chonsei price increase was not directly derived from the index of financial industry, but the finance industrial index affected Chonsei price increase.