• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.49-60
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• 2022

Background: Although dental sedation helps control anxiety and pain, side effects and serious complications related to sedation are gradually increasing. Due to the introduction of new drugs and sedation methods, insurance rates, legal regulations, drugs, and methods used for dental sedation are inevitably changed. In the Republic of Korea, National Health Insurance is applied to all citizens, and this study investigated changes in the use of sedatives using this big data. Methods: This study used customized health information data provided by the Healthcare Insurance Review & Assessment Service of Korea. Among patients with a record of use of at least one of eight types of sedatives for dental sedation between January 2007 and September 2019 were selected; the data of their overall insurance claims for dental treatment were then analyzed. Results: The number of patients who received dental sedation was 786,003, and the number of dental sedation cases was 1,649,688. Inhalational sedation using nitrous oxide (N₂O) accounted for 86.8% of all sedatives that could be claimed for drugs and treatment. In particular, it was confirmed that the number of requests for sedation using N₂O sharply increased each year. Midazolam showed an increasing trend, and in the case of chloral hydrate, it gradually decreased. Conclusion: According to our analysis, the use of N₂O and midazolam gradually increased, while the use of chloral hydrate gradually decreased.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.38-47
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• 2020

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

• Research in Community and Public Health Nursing
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• v.23 no.4
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• pp.415-426
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• 2012

Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.433-437
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• 2006

Objectives: The aim of this study is to develop a methodology for estimating a nationwide statistic for hernia operations with using the claim database of the Korea Health Insurance Cooperation (KHIC). Methods: According to the insurance claim procedures, the claim database was divided into the electronic data interchange database (EDI_DB) and the sheet database (Paper_DB). Although the EDI_DB has operation and management codes showing the facts and kinds of operations, the Paper_DB doesn't. Using the hernia matched management code in the EDI_DB, the cases of hernia surgery were extracted. For drawing the potential cases from the Paper_DB, which doesn't have the code, the predictive model was developed using the data mining technique called SEMMA. The claim sheets of the cases that showed a predictive probability of an operation over the threshold, as was decided by the ROC curve, were identified in order to get the positive predictive value as an index of usefulness for the predictive model. Results: Of the claim databases in 2004, 14,386 cases had hernia related management codes with using the EDI system. For fitting the models with applying the data mining technique, logistic regression was chosen rather than the neural network method or the decision tree method. From the Paper_DB, 1,019 cases were extracted as potential cases. Direct review of the sheets of the extracted cases showed that the positive predictive value was 95.3%. Conclusions: The results suggested that applying the data mining technique to the claim database in the KHIC for estimating the nationwide surgical statistics would be useful from the aspect of execution and cost-effectiveness.

• Korean Journal of Occupational Health Nursing
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• v.25 no.1
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• pp.19-28
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• 2016

Purpose: This study was a descriptive research to identify the effects of communication skills, compassion satisfaction, compassion fatigue on burnout among staff of long term care insurance for the elderly in National Health Insurance Services in Korea. Methods: A descriptive cross-sectional design was used. The participants were 191 staffs of long-term care insurance in National Health Insurance Services. Data were collected via mail from the 24 branch offices which were randomly selected among the total of 226 centers of National Health Insurance Corporation. Stamm's professional quality of life (ProQOL) and Communication Skills Test tool were included in questionnaire to detect. SPSS/WIN 20.0 was used to conduct the descriptive statistics, t-test, ANOVA, correlation analysis, and multiple regression. Results: Compassion fatigue had a significant positive effect on burnout, while Compassion satisfaction had a negative effect on burnout. The explained variance for burnout was 69% and compassion fatigue was the most significant factor in burnout among staff of long term care insurance services. Conclusion: The results indicate that the factors influencing staffs' burnout are compassion fatigue, compassion satisfaction, and education level. Therefore, strategies to decrease compassion fatigue and improve compassion satisfaction are needed to decrease burnout for staffs of long-term care insurance in National Health Insurance Services.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.438-446
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• 2006

Objectives: We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. Methods: The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. Results: This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). Conclusions: Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.

• Journal of the Korean Data and Information Science Society
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• v.21 no.2
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• pp.201-209
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• 2010

Due to the dramatic increase of mortality from ischemic heart disease (IHD) during the last decade, it is highly warranted to present the effective prevention strategy. Therefore this study identified the major risk factors of IHD over 10 years of follow-up among 2,268,018 participants of National Health Insurance Exam in 1996 with Cox proportional hazard model. In men, BMI, blood pressure, smoking were significantly associated with IHD, whereas hypertension, perceived health status and ${\gamma}$-GTP were related with IHD in women.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.319-329
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• 2015

Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.1
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• pp.25-41
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• 2022

Background & Objectives : As the government of South Korea implemented policies to strengthen health insurance coverage, the health insurance benefit for raw herbal medicines has been promoted. This study investigated the current status of the herbal medicines coverage in the Japanese national health insurance to secure reference data for the design of herbal medicines coverage in South Korea. Methods : Literature review was conducted to collect and analyze the history and current situation on herbal medicines coverage in the Japanese health insurance system. To supplement the contents not presented in the documents, on-site interviews were conducted at the medical institutions and pharmacies that prescribed or prepared herbal medicines in Tokyo, Japan. The contents of the survey included the background and progress of the herbal medicines coverage, the status of herbal medicines use, the payment system, and the safety management of herbal medicines. Results : Since the introduction of health insurance in the 1960s, Japanese insurance system has covered herbal medicines, and so far, it has been maintained without any additional restrictions. When the raw herbal medicines are prescribed to outpatients, the preparation fee is set higher than that of other medicines, but overall payment regulations and systems for herbal medicine are generally the same as other medicines. Conclusions : The case of Japan can be a useful references and implications for national health insurance policy on herbal medicines in south Korea.

• Korea Journal of Hospital Management
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• v.28 no.1
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• pp.24-36
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• 2023

Purposes: The purpose of this study was to analyze the factors associated with current smoking status in Wonju-si and Chuncheon-si, and to study the cause of difference in smoking rates between these two regions. Methodology: Data was from the National Health Insurance Service database from 2019 to 2020. Current smoking status was based on the response to the health examination questionnaire. Logistic regression analysis was conducted to identify factors associated with current smoking status. The study included 207,307 individuals from Wonju-si and 173,698 individuals from Chuncheon-si. Findings: The smoking rate of Wonju-si was 19.83%, and Chuncheon-si was 18.20%, showing a difference in the smoking rates between the two regions. Logistic regression analysis found that men, those aged 40-49, being a self-employed insured, a medical-aid beneficiary, having a lower income, working in construction, transport, storage, communication, or manufacturing industries, having a high-risk drinking level and being underweight were significantly associated with a higher likelihood of smoking(p<0.05). Additionally, having a chronic disease was associated with a lower likelihood of smoking in the case of Chuncheon-si(p<0.05). Practical Implication: This study found the differences of factors associated with smoking rates between the two regions and could provide implications for establishing intervention programs or policies that could contribute to lowering the smoking rate in areas with high smoking rates.