• 보건행정학회지
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• 제11권2호
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• pp.85-122
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• 2001

This study compared and analyzed the effect of income-redistribution, collecting data on the basis of the estimated details of insurance contribution and individual money wage lists for each one year before and after the combination of medical insurance program for industrial workers, by systematic sampling, extracting 4,160 families(14,764 people) among people applied to medical insurance program for self employees in Taegu City on the basis of Oct. 1st in 1998 with 227 associations of medical insurance program for self employees and medical insurance program for government employees and private school teachers combined, comparing the effect of income redistribution of before and after the combination of medical insurance program for self employees. The insurance contribution by household after the combination of medical insurance program for self employees showed the increase rate of average 20.9%, among them households of 68.8% increased and 31.2% decreased. The effect of income-redistribution was more positive because the degree of inequality was more deepened from 0.64 of the before-combination to 0.45 of the after-one in decile distribution ratio, from 0.26 to 0.34 in Gini -coefficient. Decile distribution ratio on the basis of insurance benefits by household was from 0.09 in the before-combination to 0.14 in the after-one, Gini-coefficient from 0.16 in the before-combination to 0.57 in the after-one was a little lowered. And decile distribution ratio of insurance benefits on the basis of insurance contribution was higher from 1.08 in the before-combination to 1.23 in the after-one, concentration index was a little lowered from 0.14 to 0.11, the effect of income-redistribution was improved in the phase of insurance benefits. The income-transfer rate of medical insurance program for self employees (the occupied rate of insurance benefits/ the occupied rate of insurance contribution) showed a lower trend in all of the before and after-combination towards upper classes, it was known that the income-transfer rate was higher from 1st degree to 7th degree in the after-combination in comparison with the before-one, but the effect of income¬redistribution was high because the income-transfer rate was lowered from 8th degree to 10th degree. The rate of medical insurance benefits (insurance benefits/ insurance contribution) increased from 0.79 in the before-combination to 1.07 in the after-one, and showed over 1.0 under 3th degree before the combination, but all of it was higher than 1.0 under 7th degree after the combination, the after-combination was more improved than the before-one in view of the rate of insurance benefits. As the result of above, on the basis of Oct. 1st in 1998 that 227 associations of medical insurance program for self employees was combined into one, we could say that the equality of imposing medical insurance contribution was more re-considered in the after-combination than in the before-one. But this study analyzed with classes divided, anyway, on the basis of insurance contribution, we have limit in explaining the correct effect of income-redistribution, because it was not analyzed according to classes of income, though it helps to analogize the effect of income-redistribution. So there must be analysis about the effect of income-redistribution, on the basis of the system, building up the system to grasp the correct income of the insureds of medical insurance program for self employees.

• 보건행정학회지
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• 제8권1호
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• pp.135-154
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• 1998

In Korea, the institutional reform for the national medical insurance system is in process. Eventually, three kinds of the national medical insurance system, i.e., medical insurance program for the industrial workers, the govemment employees and the private school teachers, and the self-employeds, would be merged into an unifed system. In this study, I analyzed the annual trends of the finance in the medical insurance system in Korea, in which I found the financial instability especially in the medical insurance program for the self-employeds. The regression analysis was carried out to forecast the accumulated reserve at the end of this year for the medical insurance program for the self-employeds. I also analyzed the economic effect of the merge of the medical insurance program for the self-employeds by using the case of Japan and Korea. I found that the medical insurance for the self-employeds is expected to have financial deficit at the end of the year 1998 after the merge. In onclusion, it seems to be quite difficult to solve the financial instability in the medical insurance program for the self-employeds after it would be merged. That means that there would be a lot of problems on the way to the merge.

• 보건행정학회지
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• 제4권1호
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• pp.77-106
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• 1994

This study attempts to evaluate the beneficial equity and operational efficiency of the three Korean medical insurance programmes and thereby suggest directions for their policy improvement. Concepts of the equity and effciency were reviewed to develop indicators for comparative analysis. For the analysis, statistical and financial accounting data for 1991, issued by the National Federation of Medical Insurance and the Korea Medical Insurance Corporation, on the operational status and performances of the programmes, were collected and rearranged to be suited to the purpose of the study. The analysis reveals that beneficial inequity exists between self-employed and employee programs. and that operational inefficiency is prominent in both programms for self-employeds and for Government employees and private school teachers. In order to improve the beneficial inequity of the self-employed program, it is suggested that policies be formulated and implimented toward increasing the program revenue through increasing subsidies from the Government, and through inter- program finance adiustment. For the operational inefficiency of the two programs, it is judged that, toghether with the administrative support and control from the Government and the insurance society bodies, self- efforts be initiated to improve the internal mangement styles and systems of the insurance societies. Finally, from the viewpoint of the structural efficiency, expansion of the preventive insurance benefits by the insurance soceties is recommended both for beneficial equity and operational efficiency.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.28-34
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• 2001

Objectives : To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. Methods : The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 8 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. Results : The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997 Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. Conclusions : Medical utilization in 1998 deceased in relation to 1997 Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu region' decreased mere than the other regions.

• 보건행정학회지
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• 제10권3호
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• pp.108-128
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• 2000

The Korean government has implemented the policy for merging 141 health insurers into Korean Unified Health Insurer (KUHI) in July of 2000. The unification of multiple insurers will definitely effect the stability of financial management, equity of premium burdens and efficiency of administrative management. However, it is difficult to predict what forms the far-reaching effects of the unification would take. Thus, pursuing the unification may be express as a huge policy experiment. In order to lead the unification, which lies on a crossroad between success and failure, to the road of success, we need to infer the problems and obstacles predicted in the step-wise processes of merging organizations, finances and the systems of computing premium, and come up with the effective means to maintain the stability of financial management, to improve the equity of premium burdens and to increase the efficiency of administrative management. Thus, I first described the changes of the Korean medical insurance system, and analyzed the performances of self-employed medical insurance 1 year after the integration of societies in October of 1998. At the base of examining the stability of financial management, equity of premium burdens and efficiency of administrative management, I predicted the problems and obstacles that could occur after the unification of the multiple medical insurers, and proposed a few ways of leading the unification of the multiple medical insurers in Korea to success. The most worried factor is that insurance finance would become unstable since the expansion of premium revenues is not easy because raising the premium for all Koreans is to be difficult. In addition, the unification of insurance finance could weaken the insurer's efforts for declaring real incomes of the self-employed and increasing the collection rate of premiums from them. This weakening would be the decisive factor of lowering the equity of premium contributions between the self-employed and employees. And bureaucratization and rigidity that are unavoidable in a gigantic unified organization could lower the efficiency of administrative management. Furthermore, by having 3 labor unions in the unified organization, it is possible to experience frequent difficulties and discords among the unions and between the unions and organization. Thus, when smooth pursuing of the unification of multiple insurers gets difficult, the social expenses derived from the failure would eventually end up on all Koreans. The unification is to be performed after coming up with the ways to eradicate these worries, so that the unification of multiple insurers would step onto the road of success.

• 보건교육건강증진학회지
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• 제6권2호
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• pp.23-39
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• 1989

There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

• 보건행정학회지
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• 제6권1호
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• 유통과학연구
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• 제16권7호
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• pp.77-86
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• 2018

Purpose - In the insurance distribution channel, the salespeople plays a role of representing the company, and recognizes the needs of the customers and plays a role in responding to them. Therefore, their turnover can have a great influence on the company performance. The purpose of this study is to investigate the structural relationship between salespeople's personal - environmental fit and organizational commitment and turnover intention. Research design, data, and methodology - Data collection was conducted a self-filling questionnaire for salespeople for about one month from July 24, 2017 to August 30, 2017. The subjects of the questionnaire were the insurance salespeople who work in the sales line such as K life, S fire. A total of 450 copies were distributed and 432 copies of the questionnaire were used for final analysis. The analysis program used SPSS 22.0 and AMOS 22.0 programs. Analysis method was Frequency Analysis, Reliability & Confirmatory Factor Analysis, Correlation Analysis and Structural Equation Model(SEM). Results - As a result of Hypothesis 1, Person-Supervisor Fit had significant influence only on Continuance Commitment. Person-Job Fit did not have a significant effect on Organizational Commitment. Person-Coworker Fit had a significant effect on Continuance Commitment and Affective Commitment. Person-Organization Fit had a significant impact on Affective Commitment. Therefore, only , , , , were adopted. As a result of Hypothesis 2, Continuance Commitment had a significant effect on turnover intention. Therefore, only was adopted. Conclusions - This study suggests that it is necessary to manage the human resources in the sales field through studies related to salespeople's extension of the research scope and salespeople's turnover intention. Based on the results of this study, the conclusion suggests some implications for the efficient human resources management of insurance companies in sales channels. It is expected that it will be helpful for the salespeople to find out what kind of Person-Environment Fit affects the organizational commitment and how to manage the organizational commitment among the three dimensions of organizational commitment to reduce turnover intention.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.29-44
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• 1989

도시지역 주민의 의료기관 이용률과 그 관련요인을 조사분석 하기 위하여 1988년 7월 3일부터 7월15일까지 1단계 단순집락 표본추출을 통하여 선정한 대구시 남구 지역의 450가구를 대상으로 면접조사를 실시하여 431가구 1,723명에 대한 자료를 분석하여 다음과 같은 결과를 얻었다. 대상자 1,000명당 조사기간 2주간의 급성이환율은 101이었고 9세이하군에서 202로 가장 높았고, 지난 1년간 만성이환율은 77이었으며 고연령층, 저소득층 그리고 의료보호 적용군 등에서 유의하게 높았다(p<0.01). 대상자 1,000명당 2주간의 의료기관 이용률은 689이었고, 이중 병의원이용률이 294로 가장 높았고, 약국 보건소 그리고 한의원 및 한약방 순이었다. 성별로는 여자가 785회로 남자 591보다 높았으며, 연령별로는 70세이상 군이 2,022회로 가장 높았다(p<0.01). 그외 특성에서는 의료보호 적용군 2,057(p<0.01), 월30만원미만 소득군 346, 자영업이 907로 가장 높았다. 2주간의 의료기관 이용자 1인당 평균 방문회수는 3.25회이었고, 이중 병의원이 3.26회로 가장 많았으며, 한의원 및 한약방, 약국 그리고 보건소 순이었다. 성별로는 여자가 3.47회로 남자보다 많았다. 그외 50대연령군이 5.02회, 의료보호적용군 6.41회, 월30만원미만 소득군 3.78회, 그리고 생산직이 3.64회로 가장 많았다. 대상자 1,000명당 연간입원율은 27.6이었고, 여자 38.9 남자 16.3으로 여자가 높았고 연령별로는 70세이상군이 133.3으로 가장 높았다. 의료보장상태별로는 의료보험적용군이 비적용군보다 2배이상 높았으며, 의료보호적용군에서는 한건도 없었다. 월 30만원미만 소득군이 20.8로 가장 낮았으며 소득이 증가할수록 입원율이 높아졌다. 직업별로는 무직 및 기타직이 35.9로 가장 높았고, 전문, 관리 및 사무직이 가장 낮았다. 입원의료 이용자 1인당 연평균 입원일수는 총 22.5일이었으며, 성별로는 남자가 28.1일로 여자보다 많았다. 연령별로는 40대가 72.3일로 가장많았다. 직장, 직종 및 지역의료보험적용군이 28.8일, 월 30만원미만 소득군이 44.5일 그리고 무직 및 기타직이 21.9일로 가장 많았다. 대상자 1,000명당 연간 총 입원일수는 560일이었으며, 여자가 661일로 남자보다 많았으며, 연령별로는 70세이상군이 2,800일로 가장많았다. 의료보험 적용군이 비적용군보다 3배이상 많았으며, 직업별로는 무직 및 기타직이 789일로 가장 많았다. 2주간 병의원 이용여부를 종속변수로 한 지수형회귀분석에서 유의한 계수는 9세이하군(+), 70세이상군(+), 급성질병(+), 만성질병(+), 공 교의료보험적용(+), 직장, 직종 및 지역의료보험적용(+) 그리고 전문, 관리 및 사무직(-) 등이었다. 약국이용여부 분석에서는 9세이하군(+), 50-69세군(+), 70세이상군(+), 금성질병(+), 만상질병(+) 그리고 공.교의료보험적용(-) 등이 유의하였다. 2주간의 병의원 외래이용회수에 대한 중회귀분석에서는 급성질병(+), 만성질병(+) 직장, 직종 및 지역의료보험적용(+), 전문, 관리 및 사무직(-) 등이 유의한 변수였으며, 약국이용회수 분석에서는 급성질병(+), 만성질병(+), 공.교의료보험적용(-) 그리고 직장, 직종 및 지역의료보험적용(-)등이 유의하다. 연간 입원의료 이용여부에 대한 지수형 회귀분석에서 통계적으로 유의한 변수로는 9세이하군(+), 70세이상군(+), 만성질병(+), 공.교의료보험적용(+) 그리고 직장, 직종 및 지역의료보험적용(+) 등이었다.

• 산업진흥연구
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• 제8권4호
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• pp.61-67
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• 2023

본 연구는 산업안전보건법에 따라 지정·등록하는 안전관리전문기관에서 안전관리를 대행하는 사업장과 안전관리를 자체 수행하는 사업장의 사고재해율과 사고사망만인율을 비교 분석·검증하였다. 연구결과에 따르면 사고재해율이 낮은 집단은 안전관리자를 자체 선임한 사업장, 규모는 근로자 300인 미만 자체 선임 사업장, 산재보험 업종은 제조업과 운수·창고·통신업의 자체선임 사업장으로 유의성을 확인하였다. 사고사망만인율이 낮은 집단은 근로자 300인 미만 안전 관리전문기관의 대행 사업장과 기타의사업의 자체 선임 사업장으로 나타났다. 그 외 집단의 분석에서는 사고재해율과 사고사망만인율의 유의성을 확인할 수 없었다. 본 연구에서 안전관리전문기관의 대행 사업장에서 사고재해율이 자체 선임사업장 보다 높고, 사고사망만인율은 규모와 업종에 따라 일부 차이가 있는 것을 확인하였다. 따라서, 현재의 안전관리의 대행제도로는 사고사망 등 산재예방 효과를 담보할 수 없으므로 대행제도의 개편과 안전관리자를 대상으로 산업재해 및 사고사망 예방 전문성 강화를 위한 제도의 개선이 필요하다.