• Title/Summary/Keyword: private health insurance

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The Effect of Private Health Insurance on Health Care Utilization: Evidence from Korea Health Panel (2008~2010) (민간의료보험이 의료 이용에 미치는 영향: 한국의료패널(2008-2010)을 이용한 Two-Stage 분석)

  • You, Chang-Hoon;Kang, Sung-Wook;Choi, Ji-Heon;Oh, Eun-Hwan;Kwon, Young-Dae
    • The Korean Journal of Health Service Management
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    • v.8 no.2
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    • pp.101-113
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    • 2014
  • This paper examined the effects of private health insurance(PHI) on the health care utilization among the Korean. The used data was the three waves of Korea Health Panel (2008, 2009, 2010), and the number of subjects was 13,951 persons. Authors employed two-stage least square panel model where the instrument variables for controlling for endogeneity of PHI were number of insurance planner per 100,000 in resident area and whether subject worked on financial profession. The results showed that healthcare expenditure of outpatients who purchasing PHI was higher than that of outpatients without PHI, and there was no difference in admission between the two groups. This article recommended the Korean government to monitor the effects of PHI on the health care utilization in order to improve the efficiency of health care finance.

Overview and Insight After 30 years of implementing the National Health Insurance Regulations in Korea (한국 건강보험법 시행 30년의 역사와 과제)

  • Shin, Un-Heng
    • The Korean Society of Law and Medicine
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    • v.8 no.2
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    • pp.9-35
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    • 2007
  • The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.

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Determinants of Purchasing Indemnity Private Health Insurance among Adolescents and Children (소아 및 청소년의 실손형 민간의료보험 가입 결정요인)

  • You, Chang Hoon;Kang, Sungwook;Choi, Ji Heon;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.99-110
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    • 2018
  • As interest in adolescent and children's health risks increases, there is an increase in subscriptions to indemnity private health insurance. The purpose of this study was to investigate determinants of purchasing indemnity private health insurance. We conducted panel logit regression analysis on the sample of 4,567 adolescent and children using Korean Health Panel data from 2009 to 2015. As a result, it was analyzed that the participation of private health insurance for children and adolescents was affected not only by the characteristics of children and adolescents (age, birth order, residence, disability) but also by the characteristics of father (indemnity, disability, chronic disease) and mother (age difference between her and her children, indemnity, unmet needs) and the economic level of households (income). In views of this study, it is necessary to continuously implement policies to strengthen the healthcare of children and adolescents in order to alleviate the anxiety about the health risks of children and the burden of medical expenses caused by late marriages and maternal births. In particular, it is necessary to consider policies for multi-child families and vulnerable classes.

Factors Associated with the Middle-aged or the Old-aged Koreans' Enrollment in Private Health Insurance (국내 중고령층의 민간의료보험 가입에 대한 영향 요인)

  • Kim, Hyo-Jin;Lee, Jae-Hee
    • The Journal of the Korea Contents Association
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    • v.12 no.12
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    • pp.683-693
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    • 2012
  • In this study we investigated the factors determining people's decision on whether to subscribe to private health insurance, on how many private health insurances they subscribe to and the average amount of monthly payment from subscribers of private health insurances. For analysis, logistic regression analysis and multiple linear regression analysis were conducted on the sample of 8,167 people using 2008 Korean Longitudinal Study of Ageing(KLoSA) data. From the analysis, whether to enroll in private health insurance is found to be greatly influenced by population and socioeconomic factors as well as regular exercise, smoking, cognitive function scores, subjective health status, hospitalization, the number of outpatient services, free primary health screenings benefits. We also found that number of private health insurances purchased is affected by age, household income, subjective health status, drinking, free primary health screenings benefits and that the average amount of monthly payment for private health insurances purchased is influenced by age, marriage status, economic activities status, subjective sense of hierarchy, household income, drinking, hospitalization. This study is expected to contribute to show the healthy role of private health insurance so that the desirable direction in expansion of health security policy in Korea can be explored further.

Ubiquitous Environment with Private Health Insurance and the Relevance of Length of Stay (유비쿼터스 환경에서 민영의료보험 가입과 입원기간과의 관련성)

  • Jang, Dong-Ruyl;Choi, Seong-Woo;Park, Bu-Yeon;Kim, Sung-Gil
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.2
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    • pp.203-209
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    • 2014
  • The purpose of this study was to analysis of influence between of private health insurance and length of stay with cervical and lumbar simple sprain patients at Ubiquitous medical environment. They were diagnosed as having sprain of cervical and lumbar spine without neurological symptoms in hospitals and clinics from July 1, 2010 to February 29, 2012. This study was t-test, ANOVA and multiple regression analysis. The results were when the number of private health insurance was input as an independent variable, the subjects had one or two accidental insurances(${\beta}$=2.731, P=0.013), length of stay in beds was longer than they had no accidental insurance and when they had more than three ones(${\beta}$=4.991, P=0.000), length of stay was significantly longer. This study has a meaning in that it is domestic practical study which identified relationships between entry of private health insurance and length of stay.

The Job Stress and Mental Health of the Insurance Reviewer (보험심사 근무직의 직무스트레스와 정신건강)

  • Kyoungjin Song;Jeongwon Lee
    • Journal of Service Research and Studies
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    • v.11 no.1
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    • pp.31-44
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    • 2021
  • The net function of the domestic medical insurance system is highly regarded, but due to the problem of incomplete coverage, the public wants to secure coverage through private medical insurance subscription. As a result, the subscription rate of private medical insurance has recently increased, and the billing rate has also increased. As the number of people seeking private medical insurance increased, workers at private medical insurance companies are experiencing increased job stress and side effects, especially for insurance reviewers who are in charge of paying insurance, such as communicating with customers who claimed insurance and contributing to the company's profit. In response, this study analyzed the effects of job stress on mental health of insurance reviewers and conducted a descriptive survey study to reduce job stress of insurance reviewers and promote mental health. The analysis shows that job stress for insurance reviewers has a significant impact on mental health (+). In detail, job stress has a significant impact on all four factors: social performance and self-confidence, depression, sleeping disturbance and anxiety, and general well-being and vitality. This study showed that job stress in insurance reviewers has a significant (+) impact on mental health. Job stress can cause side effects in organizational aspects, such as reducing enthusiasm for job performance and increasing turnover and resignation rates, but it can also worsen individual physical health and cause diseases such as depression and anxiety, causing mental health to be impoverished. Therefore, in order to prevent this, appropriate work stress prevention methods and countermeasures should be provided to help reduce work stress and improve mental health.

A Study on the Online-based one-stop private health insurance claims (온라인 기반 원스톱 실손의료보험료 청구에 관한 연구)

  • Lee, Kyounghak;Kang, Min-Soo;Lee, Jae-Yeul
    • Journal of Digital Convergence
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    • v.14 no.4
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    • pp.231-237
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    • 2016
  • The private health insurance covers areas that are not covered by the national health insurance to reinforce insurance guarantee. Realistically, however, many people renunciate small sum insurance claims because the inconvenient claim procedures require a certificate from the hospital for resubmission to the insurance company, which is very time consuming. Therefore, One-stop insurance payout claiming system that is capable of one stop processing of the issuance of e-page safer technology-based certification to claiming of insurance payout by utilizing authorized electronic address (#-mail) through the utilization of private information concealment technology and identification certification technology for the convenience of the subscribers and the simplification of operation was developed.

Approach to History and Problems of Health Insurance through Politics of Law (국민건강보험법의 발전과정과 법정책적 과제)

  • Cho, Hyong-Won
    • The Korean Society of Law and Medicine
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    • v.8 no.2
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    • pp.37-68
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    • 2007
  • Health insurance has gone far toward solving Korea's health related problems through thirty years. Health Insurance as social security system has a role of national system to secure national health. But there are many problems in health insurance. There is a dispute about many issues, coverage of health security, compulsory appointment of health insurance organization, coverage and level of health insurance benefit, decisionmaking right of health insurance price, examination of health insurance etc. Generally, the opinion for health insurance policy to be leaded by nation sets against the opinion to be leaded by private sector. It is necessary to study politics of law, constitute law and comparative law for rational solving these problems. If desirable setting of health law system can be made, legal system must be set during a long time and be discussed synthetically in different standpoint.

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The Private Health Insurance Market in the UK over the Period 1986 -1995 : an Analysis of Main Developments

  • Hong, Seon-U
    • Research in Community and Public Health Nursing
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    • v.8 no.2
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    • pp.403-415
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    • 1997
  • 이 논문은 지난 10년간(1986-1995)의 영국의 사건강보험(private health insurance) 시장의 전반적 추이를 관찰, 국민 의료 써비스(National Health Service)와의 관계 및 역할 변화를 고찰한 것이다. 가장 대표적인 PMI(private medical Insurance)와 PHI(permanent health Insurance), LTCI(long term care insurance)를 집중 연구하였으나 지면관계상 PMI를 중점적으로 다루고 PHI나 LTCI는 간략히 소개하였으며 관련도표는 모두 생략하였다. 영국의 사건강보험 시장은 1990년대 초의 정체기를 거친후 이제 서서히 가시적인 성장을 보이고 있다. 많은 영국 국민들은 정부가 기본적인 복지혜택 외에는 더 이상의 치료와 미래 간호를 보장할 수 없다는 사실을 이해하고 있으나 아직 대부분은 어떤 형태로든 NHS 외의 보호장치를 가지고 있지 못하다. 따라서 영국민의 사건강보험에 대한 관심은 점차 고조되고 있는 것이 현실이다. 사건강보험 시장의 성장은 몇가지 중요한 요소에 좌우된다 첫째, NHS의 capacity이다. 달리 말하면, NHS에 대한 정부의 각종 정책과 태도는 시장에 직접적인 영향을 미친다. 둘째, 경제성장은 상당히 결정적인 요소이다. 1990년대 초의 침체에서 이미 보았듯이 경기후퇴와 그와 동반된 높은 실업은 사적 의료써비스의 구매력을 감소시킨다. 셋째, 시장을 극대하려는 보험회사의 노력 또한 배놓을 수 없는 중요한 요소이다. 새로운 구매자를 위해서 또 시장에서의 치열한 경쟁에서 살아 남기 위해서 보험회사들은 폭넓은 범위의 상품을 개발하고 노동자들을 위한 값이 저렴한 상품들을 소개시켜 왔다. 비록 이런 종류의 저렴한 상품들은 커버하는 범위가 불충분하지만 총 인구의 보험 가입을 증가시킨다. 현 상황에서 PMI는 NHS에 대한 대안이 되지 못하고 단지 부분적 대용책일 뿐이다. 또한 시장을 극대시키려는 정부의 노력에도 불구하고 극소수의 사람들만이 PHI에 커버되고 있다. LTCI는 너무 비싸 지극히 부자들만이 구매할 수 있을 뿐, 평균임금 또는 그 이하의 사람들은 보험료를 감당할 수 없다. 한편. 영국의 사건강보험 시장에 대한 전망 또한 복합적이다. 즉 PMI 부문은 서서히 성장, PHI 부문은 계속적으로 꾸준히 증가, LTCI 부문은 제한적이기는 하나 발전하리라 보는 것이다. 따라서 미래시장을 예견하는 것은 그리 쉽지 아니하다. 결론적으로 영국국민은 질병, 또는 치료가 필요한 경우 전적으로 NHS에 의존하고 있으며 현재의 사건강보험은 다양한 질병위험에 대한 보호를 제공하기보다는 단순히 부가적인 혜택에 지나지 않을 뿐이다.

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The Influences of Economic, Social Factors on the Subjective Health Assessment for Baby Boomer Generation Workers -the Moderating Effect of Private Health Insurance- (베이비부머세대 근로자의 경제, 사회요인이 주관적 건강평가에 미치는 영향 -민간의료보험가입 조절효과-)

  • Heo, Won-Gu
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.257-272
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    • 2015
  • This study is to verify how the economic, social and moderating effect factors of baby boomer generation workers' affect the subjective health evaluation. The subjective of this study was 1,202 workers of baby boomer generation by using the 4th data of Korea longitudinal study of aging(KLoSA) from Korea Labor Institute in 2012. Economic and social factors were selected as scales to analyze if there is meaningful difference in subjective health evaluation. Method of frequency analysis, t-test, ANOVA and correlation analysis was used, and multi regression analysis was also conducted to verify whether the private health insurance has control effect over the relation between the subjective health evaluation and the economic & social factor. As a result of the study, age, education, home ownership, peer group meeting, overall satisfaction, private health insurance were major factors affecting the subjective health evaluation of baby boomer generation. Moreover private health care were turned out to have a moderation effect in relation between economic, social factor and subjective health evaluation.