• Dementia and Neurocognitive Disorders
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• v.16 no.1
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• pp.1-6
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• 2017

The purpose of this study is to examine interventions and supporting systems by dementia stage, take a look at dementia insurance policies in Korea and the United States, and present Korean private insurance programs for dementia patients. According to the study, our suggestions of a design of private insurance products for Korean dementia patients are as follows. First, the products should support people aged 80 and older. Second, new products should include the mild stage dementia in the insurance coverage. Third, non-pharmacological treatments, such as the cognitive stimulation, the cognitive training, and exercises need to be covered through the new private insurance. Fourth, the private insurance should be contained home health care services in its coverage. These suggestions can reduce the dependence of the public insurance, help people choose appropriate treatments for themselves, and give people a good opportunity to improve the effect of dementia treatment and to increase the satisfaction of patients and their families.

• Korea Journal of Hospital Management
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• v.24 no.3
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.42-53
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• 2018

Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

• Health Policy and Management
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• v.19 no.1
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• pp.62-80
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• 2009

The purpose of this study was to examine the factors influencing the attitude toward the increasing role of private health insurance(PHI). In the Korea Welfare Panel Data 2007, a sample of 1,675 (adjusted by weight value: 1,607) respondents on an opinion on promoting PHI was used in the study. With independent variables including socio-demographic characteristics, health status, health-related behavior, and opinions on welfare service, ordered-probit model was used to analyze the attitude toward PHI. Negative opinion on the increasing role of PHI were responded by 54.6%(n=877) of the respondents, whereas 22.2%(n=373) were positive and 23.2%(n=357) were neutral. Old people, the better off, those with worse self-assessed health status, and those having an experience of health examination tend to have the positive attitude toward the increasing role of PHI. Women, those with chronic diseases or disorders and those who do not agree that comprehensive welfare benefits reduce work incentive showed negative attitude toward PHI. When comparing the needs for PHI before and after medical utilization, ex-ante need tends to strengthen the tendency to support private health insurance. This study will contribute to the discussion on the optimal mix of public and private health insurance in Korea by a better recognition of attitude toward PHI and health care system.

• Journal of Preventive Medicine and Public Health
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• v.40 no.2
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• pp.150-154
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• 2007

Objectives : The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. Results : Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of \65,311 and an average benefit amount of \19million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. Conclusions : About half of Korean people have supple-mentary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.

• Health Policy and Management
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• v.31 no.4
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• pp.423-436
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• 2021

This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

• Journal of Convergence for Information Technology
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• v.11 no.10
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• pp.194-204
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• 2021

This study was conducted to find out the status and factors of private health insurance subscriptions by life cycle and to identify differences in medical usage behavior by life cycle. Using the SPSS 26 program as the 12th-15th (2016-2019) data of the Korea Welfare Panel, the difference subscriptions was identified as Chi-square by demo social and health characteristics of 58,223 people, and the factors affecting subscription were analyzed by polynomial logistic analysis and average analysis was performed for medical use behavior. As a result of the analysis, the biggest factor in purchasing private health insurance was household income, private health insurance coverage is the highest in growth period, and multiple subscriptions were made depending on household income. In youth, household income, spouse, and no disability, and middle age, household income, economic activities, spouses, and health levels were largely influential factors. The rate of private health insurance coverage in old age was the lowest, and low-income households, poor health levels, and people with disabilities were lower. The increase in medical use by private health insurance subscribers also occurred during growth and youth. It is necessary to strengthen the national health insurance coverage, and the role of private health insurance to supplement it should be established in time for the life cycle to complement each other, eliminating blind spots of medical security and maximizing people's health and well-being.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.1
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• pp.67-81
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• 2017

Objectives : The purpose of this study was to analyze the report conducted in 2014 by the Ministry of Health and Welfares on influences of private insurance coverage on the use of Korean medicine. Methods : We analyzed Ministry of Health and welfares report on the use and consumption of Korean medicine to fit the purpose of this study. Comparison between private insurance holders and non-holders was made in the areas of sociodemographic characteristics, patient distribution by disorders, total number of disorders and existence of complex diseases, general perception of Korean medicine, and medical expenses and visits. Logistic regression analysis was made to verify the private insurance coverage. Results : Among sociodemographic characteristics, significant differences were observed in age distribution, education, professions, income level, and housing factors. But genders, area of residence, and marital status didn't show significant differences. Other significant differences including side effects, experience with Korean medicine, herbal medicine and acupuncture treatments, and main visiting facilities were shown between private insurance holders and non-holders. Majority of disorders treated with Korean medicine were musculoskeletal issues, and criteria of number of disorders, multiple diseases factors, and medical expenses/visits showed significant differences between the two groups. Conclusions : Summarizing above results indicate that holding a private insurance in addition to National Health Insurance contributes significant influences on the use of Korean medicine.

• The Journal of the Korea Contents Association
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• v.22 no.1
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• pp.601-610
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• 2022

Although the number of people insured by private health insurance in Korea is steadily increasing, the household burden or the status of multiple purchasing for private health insurance has not been addressed. In this study, data of the 2011-2018 Korea Health Panel Survey was used to examine the purchasing trend of Korean households' private health insurance. Households with more than three private health insurance per household member were defined as the 'poly-purchases'. The logit model was applied to analyze factors associated with poly-purchase of private health insurance using 2018 cross-sectional data. From 2011 to 2018, the number of insurances purchased by Korean households increased (4.0 to 4.6), the number of insurances per capita increased (1.3 to 1.6), and the proportion of the poly-purchasing households increased (5.2% to 10.8%). As a result of logit analysis, the probability of poly-purchasing was increased when the household head was a woman, with a high level of education and income, and when the job of the household head was a service or sales. Poly-purchasing was less likely when the family was subsidized with Medical Aids and suffered with more chronic diseases. The results of this study serve basic evidence for establishing policies regarding private health insurance, such as establishing the relationship between public and private insurance.