• Health Policy and Management
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• v.19 no.3
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• pp.92-108
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• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

• Journal of dental hygiene science
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• v.15 no.1
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• pp.46-53
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• 2015

The purpose of this study is to identify the awareness of oral health workforce and the attitude concerning the health insurance benefit on topical fluoride application. The subjects are 173 dentists and 288 dental hygienists. The data were collected using a self-administered questionnaire and analyzed using SPSS 12.0 statistical program. The findings of the study were as follows: Agree's (including strongly agree) ratios regarding to the health insurance benefit of topical fluoride application was 92.5% for dentists and 90.8% for dental hygienists. Appropriate age of health insurance benefit about the topical fluoride application was elementary, middle and high school students (8~19 years). This response ratio was high 45.7% for dentists and 43.2% for dental hygienists. Appropriate copayment (mean value) of health insurance about topical fluoride application coverage showed that NaF, $SnF_2$ solution and acidulated phosphate fluoride gel were 25,782 Korean Won (KRW) for dentist and 14,282 KRW for dental hygienist. Fluoride varnish copayment was 31,705 KRW for dentist and 17,979 KRW for dental hygienist. Fluoride iontophoresis copayment was 40,156 KRW for dentist, and 21,210 KRW for dental hygienist. The frequency of health insurance benefits about topical fluoride application was high in 'unlimited (37.5%)' for the dentists and 'two times (31.3%)' for dental hygienists. In conclusion, topical fluoride application should be included as one of the health insurance benefit items for oral health.

• Journal of Oriental Neuropsychiatry
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• v.33 no.2
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• pp.123-131
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• 2022

Objectives: The purpose of this study was to investigate the experience and perception of using Korean medicine treatments for patients with mental disorders. Methods: The method of a qualitative analysis was used, and semi-structured interviews were conducted. The researchers developed the survey questionnaires with consultation from psychiatrists from various university hospitals. Before conducting interviews, an IRB was approved KHSIRB-21-131 (RA), and the Hankook Research Company managed the interviews. The question composition comprised 11 questions based on symptoms and treatment situations accompanying treatment due to mental distress, perception of Korean medicine, awareness of treatment costs, and awareness of treatment costs. Results: A total of six patients were interviewed. Each interviewee took 90 minutes to answer questions. Through the analysis of the data, the patients comprised four categories: characteristics, awareness of Korean medicine, awareness of Western treatment, and daily life due to mental disorder. The experience and perception of patients using Korean medicine showed positive attitudes. There was an opinion among patients that Korean medicine treatment was less dependent on drugs, and had fewer side effects, than Western medicine. Some patients said that Korean medical treatment is expensive and burdensome medical expenses. Some patients were not aware of the application of insurance to mitigate medical expenses. Conclusions: Based on the findings of the study, it is urgent to expand the application of insurance benefits to Korean medicine.

• Journal of the Ergonomics Society of Korea
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• v.29 no.4
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• pp.405-422
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• 2010

Occupational musculoskeletal disorders currently account for the largest proportion of the occupational illnesses in Korea. In this research, status of musculoskeletal disorders among the occupational illnesses was examined through workers' compensation claims data. Types and characteristics of musculoskeletal disorders were looked at other data set as well. The data sets included epidemiological investigation data reported by Occupational Safety and Health Research Institute, and data collected from occupational disease surveillance reports and Korean occupational health-related scientific journals. Number of cases, incidence rate and insurance benefits for occupational musculoskeletal disorders in Korea are increasing every year. In addition, musculoskeletal disorders occurrence is shifted from large enterprises group to small-and-medium group, from manufacturing to service sector, and from production workers to office and professional workers. Although low back pain is still most common, its occurrence characteristics is gradually shifted from traumatic to cumulative while musculoskeletal disorders are somewhat seemingly moved from lumbar to upper limb body part. Musculoskeletal disorders were observed to be more diverse and prevalent in epidemiological investigations or surveillance data rather in workers' compensation claims data. Musculoskeletal disorders occurrence is related to demographic factors, occupational psychosocial factors, and ergonomic risk factors at workplace for which appropriate preventive measures needed to be made accordingly.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• Journal of Society of Preventive Korean Medicine
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• v.24 no.3
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• pp.27-38
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• 2020

Background : The study aimed at examining the awareness and satisfaction level of Korean medicine treatment of musculoskeletal patients and non-musculoskeletal patients. Method : The frequency and percentage were calculated to identify the overall characteristics, and to identify the characteristics of the respondents who visited the hospital to treat musculoskeletal diseases and those who visited for the treatment of non-musculoskeletal diseases, the correlation between the variables was analyzed using the chi-square analysis (χ2-test). Furthermore, analysis items were compared depending on detailed diseases within the musculoskeletal disorder (lumbar pain, sprains, arthritis, frozen shoulders, spondylitis, disc) Result : Respondents who used Korean medicine for the purpose of treating musculoskeletal diseases had answered that costs involved in Korean medicine was expensive, and answered that herbal decoction was the preferred Korean medicine treating method for expanding health insurance benefits. Regarding the safety awareness of Korean medicinal herbs, responses that said it was safe was high, and their willingness to use and recommend Korean medicine in future was also high. Respondents who used Korean medicine for the purpose of treating musculoskeletal diseases said they were overall satisfied along with the attitude of Korean medical doctors, treatment results, and costs of treatments. Conclusion : The study was aimed at securing basic data to indirectly identify the national demand for Korean medicine, through investigating the level and degree of differences that exist in the perception and satisfication level and further find a point where policy intervention is possible in future.

• Safety and Health at Work
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• v.14 no.1
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• pp.71-77
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• 2023

Background: This study investigated the relationship between trauma exposure and suicidal ideation. Moreover, this study examines the moderating roles of organizational climate on the association between trauma exposure and suicidal ideation in Korean male firefighters. Methods: A total of 15,104 male firefighters who completed a questionnaire were analyzed. The data were obtained using an online self-administered questionnaire from the Firefighter Research on Enhancement of Safety and Health Study. Poisson regression analysis was performed to determine the effects of trauma exposure on suicidal ideation and the moderating effect of organizational climate. Results: The results showed that 389 firefighters (2.6%) responded that they had experienced suicidal ideation. In the final model, trauma exposure was positively related to suicidal ideation (adjusted risk ratio [aRR], 1.076; 95% confidence interval [CI]: 1.051-1.103), and organizational climate was negatively associated with suicidal ideation (aRR, 0.772; 95% CI: 0.739-0.806). Additionally, the interaction term (trauma exposure × organizational climate) was related to suicidal ideation (aRR, 1.016; 95% CI: 1.009-1.023). Conclusions: This study suggests that trauma exposure might play a significant role in developing suicidal ideation and that positive organizational climate moderates the negative effects of trauma exposure on suicidal ideation among firefighters. It is necessary to perform a follow-up study of various intervention strategies to maintain a healthy organizational climate or work environment. Such interventions should promote lasting trust within teams, provide social support and belonging, and nurture job value.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.82-92
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• 2005

Objective : To evaluate the relationships among sociodemographic characteristics, health behaviors, levels of pros and cons and stages of change in Pap testing for uterine cervical cancer. Methods : A questionnaire survey was performed on 560 randomly sampled people who were assigned to participate in a Pap testing program by the National Cancer Screening Project in 2003' between 25 September and 10 October in Gyeonggi, Korea. Data about the behaviors and intentions of Pap testing, sociodemographic characteristics, health behaviors, and levels of acknowledged benefit (pros) and barrier (cons) for Pap testing was collected. The stages of change were grouped according to behaviors and intentions of Pap testing as passive, active, and relapse. Results : Logistic analysis between the passive and active groups showed that city dwellers, 'high' and 'middle' groups in terms of the individual s health belief, those who had undergone a health examination within the past 2 years, and those who had undergone hormone replacement therapy had a higher odds ratios to be in the active group. As the 'benefit' scores increased and the 'Unnecessity' scores decreased, the probabilities to be in the active group increased. According to the logistic analysis results between the active and relapse groups, those who were 60 years or older, members of the National Heath Insurance, and those who had not undergone a health examination within the past 2 years had a higher odds ratio to be in the relapse group. The 'Benefit' scores were not significant in this relationship. The probabilities of being in the relapse group increased as the Unnecessity and 'Shamefulness' scores increased. Conclusions : In conclusion, health planners should inform women in the passive group of the benefits and necessity of Pap testing. It would be better to reduce the barriers to the active group of undergoing Pap smear. This study might be a useful guide for future planning of Pap testing program.

• Journal of Environmental Health Sciences
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• v.48 no.1
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• pp.1-8
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• 2022

Objectives: The purpose of this study is to reveal the circumstances under which the cases of harm to health caused by humidifier disinfectant were neglected and show the points where the number of victims and the degree of damage could have been reduced. In addition, it attempts to describe how damage management proceeded immediately after the incident and actually exacerbated the damage. Finally, it explores the unfortunate aspects of the recent trial. By doing so, it attempts to take this as an opportunity to consider whether a tragic event such as the humidifier disinfectant incident could occur in the future. Methods: This study collected and analyzed data on chemical material characteristics related to humidifier disinfectants, data on health effect characteristics, data on related laws and regulations from the Ministry of Environment, data related to the damage investigation by the Korea Environmental Industry and Technology Institute, and current contents. Results: The lack of related systems and laws is the area where the greatest responsibility for the cause of the humidifier disinfectant disaster falls, so it is difficult for the government to escape this responsibility. Establishing a dedicated department to identify the prevalence of certain diseases within the functions of the Health Insurance Review and Assessment Service to monitor health can greatly contribute to the prevention and management of diseases through early detection and management of group outbreaks caused by harmful factors. Humidifier disinfectant damage relief should have been expanded earlier beyond HDLI (humidifier disinfectant lung injury) to include non-specific diseases such as asthma, pneumonia, and interstitial pneumonia. The scope of relief benefits should have also been expanded earlier to include the payment of disability benefits. Fortunately, with the 2020 revision of the Special Act, the conditions for estimating causal relations were eased and individual screening systems such as health impact assessment were reorganized along with the introduction of a rapid screening system. Conclusions: The management system for chemical substances in a country is clearly of paramount importance, and the ministry in charge must have a response system in case of damage to health effects. Administration that looks at the victims' situation from their point of view is needed, and technical countermeasures are required to quickly recognize the prevalence of certain diseases.

• Health Policy and Management
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• v.20 no.4
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.