• Title/Summary/Keyword: national health insurance data

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Assessment of Needs and Accessibility Towards Health Insurance Claims Data (연구를 위한 건강보험 청구자료 요구 및 이용 요인분석)

  • Lee, Jung-A;Oh, Ju-Hwan;Moon, Sang-Jun;Lim, Jun-Tae;Lee, Jin-Seok;Lee, Jin-Yong;Kim, Yoon
    • Health Policy and Management
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    • v.21 no.1
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    • pp.77-92
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    • 2011
  • Objectives : This study examined the health policy researchers' needs and their accessibility towards health insurance claim datasets according to their academic capacity. Methods : An online questionnaire to capture relevant proxy variables for academic needs, accessibility, and research capacity was constructed based on previous studies. The survey was delivered to active health policy researchers through three major scholarly associations in South Korea. Seven-hundred and one scholars responded while the survey as open for 12 days (starting on December 20th, 2010). Descriptive statistics and logistic regression analysis were carried out. Results : Regardless of the definition for operational needs, the prevalent needs of survey respondents were not met with the current provision of claim data. Greater research capacity was shown to be correlated with increased demand for claim data along with a positive correlation between attempts to obtain claim datasets and research capacity. A greater research capacity, however, was not necessarily correlated with better accessibility to the claim data. Conclusions : The substantial unmet need for claim data among the healthcare policy research community calls for establishing proactive institutions which could systematically prepare and make available public datasets and provide call-in services to facilitate proper handling of data.

Analysis of Health Promotion determinants in Major OECD Countries: A pooled cross-sectional time series (건강결과와 건강결정요인간의 횡단면 시계열 연구 : 주요 OECD 국가를 대상으로)

  • Choi, Yoon-Jung;Bae, Sung-Il;Lee, Young-Ho;Kang, Min-Sun
    • Health Policy and Management
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    • v.19 no.4
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    • pp.33-52
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    • 2009
  • Health promotion policies have needed to assess in detailed and evidence-based work to set a policy goal and clear future directions of health promotion in Korea. To identify the major factors related with health promotion, we assessed the associations between public health outcome (potential years of life loss, PYLL) and national health determinants. For this purpose, we used a pooled cross sectional time-series regression analysis with corrected fixed effect models involving sixteen member countries of the Organisation for Economic Cooperation and Development during the period 1970 to 2001. The PYLL was positively associated with tobacco and alcohol consumption (model 1 and 2) and calories intake (model 2 and 3) while the PYLL was negatively associated with GDP, fruit and vegetable intake (model 2), number of doctors (model 3), coverage rates of health care security, and elderly population rates (model 4). In conclusion, health behaviors related with tobacco, alcohol, and nutrition were significant health determinants for health outcome. Overall analysis results of this study will provide a guidance toward improved macro- and micro-policy development for future health promotion policy in Korea.

Is the amount of the medical care utilization affected by the cash benefits for patients in the geriatric hospital? (요양병원 간병비 지급이 건강보험 진료이용량에 미치는 영향)

  • Kang, Im-Ok;Han, Eun-Jeong;Lee, Jung-Suk
    • Health Policy and Management
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    • v.19 no.2
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    • pp.36-50
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    • 2009
  • Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.

A Study on the Late Payment Behavior of the National Health Insurance Contribution (국민건강보험 지역보험료 체납 결정요인 및 체납확률 예측모형)

  • 정우진;이선미;김원훈;신승호;조우현
    • Health Policy and Management
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    • v.13 no.2
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    • pp.85-100
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    • 2003
  • The purpose of this study is to (1) identify socio-demographic, economic, village-effect variables that influence the late payment of the National Health Insurance contribution, (2) to develop the model to predict the probability of a household to make late payment of the contribution. Data is composed of information on 78,858 households, Gangnam branch, National Health Insurance Corporation, as of September 30, 2001. We analyzed the data by using multivariate logistic regressions. The major findings are as follows; (1) an older or female householder whose family consists of smaller number of members is more likely to pay the contribution late than others, (2) as for income, one who belongs to a lower income group or nm a private business tend to pay it late, (3) more attention should be paid to a householders who does not have his/her own house or automobile so as to prevent late payment, (4) lastly, those who live in villages such as Nonhyun-l-dong are less likely to pay the contribution prior to due date.

A Path Analysis on Morale among Staff of Long-term Care Insurance in National Health Insurance Corporation (노인장기요양인정조사원의 사기에 관한 경로분석)

  • Kim, Hyun Mi;Choi, Yeon Hee
    • Korean Journal of Occupational Health Nursing
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    • v.21 no.3
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    • pp.247-257
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    • 2012
  • Purpose: This study is designed to identify major factors that affect morale among staff of long-term care insurance in National Health Insurance Corporation. Methods: In order to collect the data, a survey was conducted by using the structured questionnaire based on 161 staff members of long-term care insurance of 50 long-term care operation centers, which were randomly selected by the table of random numbers in the whole centers of National Health Insurance Corporation from September 1 to 30, 2011. As for the data analysis, SPSS 18.0 was used to conduct the descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, mutiple regression, and path analysis. Results: The average point of morale was 3.37, and had a negative correlation with the job stress, while it had a positive correlation with the social support, professional identity, and self-efficacy. Job stress, social support, and professional identity have a significant effect on morale among the independent variables. These variables have significant effects on morale, and also have a positive effect on self-efficacy. The findings show that self-efficacy mediates the process of morale. Conclusion: In this study, the factor which influences the morale was identified. It turned out that the morale could be improved by reinforcing the professional identity, managing the health status as well as rotating the working place. As such, it expects both the improvement of long-term care insurance services outcome and its quality through the morale management.

Association Between Persistent Treatment of Alzheimer's Dementia and Osteoporosis Using a Common Data Model

  • Seonhwa Hwang;Yong Gwon Soung;Seong Uk Kang;Donghan Yu;Haeran Baek;Jae-Won Jang
    • Dementia and Neurocognitive Disorders
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    • v.22 no.4
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    • pp.121-129
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    • 2023
  • Background and Purpose: As it becomes an aging society, interest in senile diseases is increasing. Alzheimer's dementia (AD) and osteoporosis are representative senile diseases. Various studies have reported that AD and osteoporosis share many risk factors that affect each other's incidence. This aimed to determine if active medication treatment of AD could affect the development of osteoporosis. Methods: The Health Insurance Review and Assessment Service provided data consisting of diagnosis, demographics, prescription drug, procedures, medical materials, and healthcare resources. In this study, data of all AD patients in South Korea who were registered under the national health insurance system were obtained. The cohort underwent conversion to an Observational Medical Outcomes Partnership-Common Data Model version 5 format. Results: This study included 11,355 individuals in the good persistent group and an equal number of 11,355 individuals in the poor persistent group from the National Health Claims database for AD drug treatment. In primary analysis, the risk of osteoporosis was significantly higher in the poor persistence group than in the good persistence group (hazard ratio, 1.20 [95% confidence interval, 1.09-1.32]; p<0.001). Conclusions: We found that the good persistence group treated with anti-dementia drugs for AD was associated with a significant lower risk of osteoporosis in this nationwide study. Further studies are needed to clarify the pathophysiological link in patients with two chronic diseases.

Comparative analysis of health insurance system and dental hygiene curriculum for 3 years (치위생학 교과의 3년간 건강보험제도 반영 비교 분석)

  • Choi, Hyo-Jin;Oh, Sang-Hwan
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.37-40
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    • 2020
  • The background of this study is the observation that there is an increase in the number of elderly persons and the decrease in fertility rates, which may be related to the increase in the average age of the Korean people; accordingly, the national health insurance system changes every year following this pattern. However, this study investigates whether these changes are reflected in the dental hygiene curriculum. Data from the national health insurance system is reviewed for the last three years, and the recently published dental hygiene curriculum is selected, compared, and analyzed using a literature survey. The study is divided into two parts: information that is reflected in the dental hygiene curriculum and information that is not reflected in the dental hygiene curriculum, but which it is believed should be included. In addition, as the part reflected in the dental hygiene curriculum, it was stated in three subjects of dental implantology, dental prosthesis, and conservative dentistry, and there were four cases. Therefore, efforts should be made to ensure that the curriculum for dental hygiene students should reflect the changes in the national health insurance system so that students can more easily understand dental insurance claim processes.

Development of Hypertension Predictive Model (고혈압 발생 예측 모형 개발)

  • Yong, Wang-Sik;Park, Il-Su;Kang, Sung-Hong;Kim, Won-Joong;Kim, Kong-Hyun;Kim, Kwang-Kee;Park, No-Yai
    • Korean Journal of Health Education and Promotion
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    • v.23 no.4
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    • pp.13-28
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    • 2006
  • Objectives: This study used the characteristics of the knowledge discovery and data mining algorithms to develop hypertension predictive model for hypertension management using the Korea National Health Insurance Corporation database(the insureds' screening and health care benefit data). Methods: This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques. Results: Major results of logistic regression analysis suggested that the probability of hypertension was: - lower for the female(compared with the male)(OR=0.834) - higher for the persons whose ages were 60 or above(compared with below 40)(OR=4.628) - higher for obese persons(compared with normal persons)(OR= 2.103) - higher for the persons with high level of glucose(compared with normal persons)(OR=1.086) - higher for the persons who had family history of hypertension(compared with the persons who had not)(OR=1.512) - higher for the persons who periodically drank alcohol(compared with the persons who did not)$(OR=1.037{\sim}1.291)$ Conclusions: This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation's building of a Hypertension Management System in the near future by bringing forth representative results on the rise and care of hypertension.

The Effect of Expanding Health Insurance Benefits for Cancer Patients on the Equity in Health Care Utilization (건강보험 암 중증질환 급여확대가 의료이용 형평성에 미친 영향)

  • Kim, Su-jin;Ko, Young;Oh, Ju-Hwan;Kwon, Soon-Man
    • Health Policy and Management
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    • v.18 no.3
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    • pp.90-109
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    • 2008
  • Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.

Goodness-of-fit Test for the Extreme Value Distribution Based on Multiply Type-II Censored Samples

  • Kang, Suk-Bok;Cho, Young-Seuk;Han, Jun-Tae
    • Journal of the Korean Data and Information Science Society
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    • v.19 no.4
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    • pp.1441-1448
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    • 2008
  • We propose the modified quantile-quantile (Q-Q) plot using the approximate maximum likelihood estimators and the modified normalized sample Lorenz curve (NSLC) plot for the extreme value distribution based on multiply Type-II censored samples. Using two example data sets, we picture the modified Q-Q plot and the modified NSLC plot.

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