• Proceedings of the Korean Institute of Intelligent Systems Conference
• /
• 2007.04a
• /
• pp.209-212
• /
• 2007

Non-additive measures and their corresponding Choquet integrals are very useful tools which are used in both insurance and financial markets. In both markets, it is important to to update prices to account for additional information. The update price is represented by the Choquet integral with respect to the conditioned non-additive measure. In this paper, we consider a price functional H on interval-valued risks defined by interval-valued Choquet integral with respect to a non-additive measure. In particular, we prove that if an interval-valued pricing functional H satisfies the properties of monotonicity, comonotonic additivity, and continuity, then there exists an two non-additive measures ${\mu}_1,\;{\mu}_2$ such that it is represented by interval-valued choquet integral on interval-valued risks.

• Journal of the Korean Institute of Intelligent Systems
• /
• v.17 no.4
• /
• pp.451-454
• /
• 2007

Non-additive measures and their corresponding Choquet integrals are very useful tools which are used in both insurance and financial markets. In both markets, it is important to update prices to account for additional information. The update price is represented by the Choquet integral with respect to the conditioned non-additive measure. In this paper, we consider a price functional H on interval-valued risks defined by interval-valued Choquet integral with respect to a non-additive measure. In particular, we prove that if an interval-valued pricing functional H satisfies the properties of monotonicity, comonotonic additivity, and continuity, then there exists an two non-additive measures ${\mu}1,\;{\mu}2$ such that it is represented by interval-valued choquet integral on interval-valued risks.

• Journal of Preventive Medicine and Public Health
• /
• v.22 no.3 s.27
• /
• pp.398-405
• /
• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• Health Policy and Management
• /
• v.28 no.4
• /
• pp.360-368
• /
• 2018

Background: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. Methods: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. Results: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. Conclusion: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.

• Health Policy and Management
• /
• v.26 no.4
• /
• pp.333-342
• /
• 2016

Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

• The Journal of the Korea Contents Association
• /
• v.21 no.6
• /
• pp.588-597
• /
• 2021

In Korea, the standard for calculating the profit of a general insurance, which constitutes the loading in the premium, is not specified, and most of the non-life insurance companies reflect 2~5% of the premium as profit margin. Although the transparency of pricing is required due to the nature of insurance products, there are insufficient standards and empirical studies on the determination of insurance price factors in the domestic insurance industry. In this study, we propose a method of calculating the expected profit margin of general insurance. A way for calculating the expected profit margin of the general insurance is to reflect the shareholder demand on the capital that the insurance company should secure against the risk of loss due to the profit/loss volatility, as a ratio to the insurance premium. Shareholders should be compensated for the risks associated with their insurance operations, and the opportunity cost of these shareholders is to be reflected in premiums. In this study, we calculate the amount of capital that the company should accumulate to prepare insurance risk for each product, and insurance risk is defined as the volatility of insurance operating profit/loss. And insurance risk is calculated using stochastic simulation based on Dynamic Financial Analysis (DFA) methodology. Finally, we calculate the expected profit margins for 25 products and analyzed the difference between those and the profit ratio of domestic general insurance.

• Communications for Statistical Applications and Methods
• /
• v.17 no.5
• /
• pp.713-724
• /
• 2010

Calculating or estimating the proper insurance premium is very important decision making process for both the policyholder and the insurance company. The credibility theory is one of the most important theories in actuarial science to get the proper premium. In this research, we introduce the rule of relative exposure volume, the square root rule and the B$\ddot{u}$hlmann credibility, and estimate the new premiums based on these methods. By real data analysis, the accuracy of these credibility methods are compared.

• The Korean Journal of Applied Statistics
• /
• v.27 no.6
• /
• pp.1017-1028
• /
• 2014

Well-known Bayes and empirical Bayes estimators have a disadvantage in respecting to overshink the parameter estimator error; therefore, a constrained Bayes estimator is suggested by matching the first two moments. Also traditional loss function such as mean square error loss function only considers the precision of estimation and to consider both precision and goodness of fit, balanced loss function is suggested. With these reasons, constrained Bayes estimators under balanced loss function is recommended for non-life insurance pricing.; however, most studies focus on the performance of estimation since Bayes risk of newly suggested estimators such as constrained Bayes and constrained empirical Bayes estimators under specific loss function is difficult to derive. This study compares the Bayes risk of several Bayes estimators under two different loss functions for estimating the risk in the auto insurance business and indicates the effectiveness of the newly suggested Bayes estimators with regards to Bayes risk perspective through auto insurance real data analysis.

• The Journal of the Korea Contents Association
• /
• v.12 no.8
• /
• pp.283-299
• /
• 2012

The aim of this study is to develop strategies activating long-term care visiting nursing. The research design was a descriptive survey study, and the data were collected from the visiting nursing center managers, customers, and long-term care insurance staffs. The major results were as follows. To activate the long-term care visiting nursing, first, the basic nursing care for ensuring sustainable health management has to be included. Second, the visiting nursing must be designated as mandatory use in standard guideline for using long-term care services. Third, the insurance pricing of visiting nursing must be based on the cost of visiting nursing. And, last, using a visiting nursing must be possible without a doctor's order sheet, when it is required for the assessment of patient's health status.

• Journal of the Korean Data and Information Science Society
• /
• v.24 no.4
• /
• pp.723-736
• /
• 2013

The importance of lapse rate is highly increasing due to the introduction of Cash Flow Pricing system, non-refund-of-reserve insurance policy, and IFRS (International Financial Reporting System) to the Korean insurance market. Researches on lapse rate have mainly focused on simple data analysis and regression analysis, etc. However, lapse rate can be analyzed by survival analysis and can be well explained in terms of several covariates with Cox proportional hazard model. Guaranteed minimum benefits embedded in variable annuities require more elegant statistical analysis of lapse rate. Hence, this paper analyzes data of policyholders with variable annuities by using Cox proportional hazard model. The key variables of policy holder that influences the lapse rate are payment method, premium, lapse insured to term insured, reserve-GMXB ratio, and age.