• Title/Summary/Keyword: public health insurance

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Recognition and satisfaction of dental care customers after 1 year national health insurance coverage of dental scaling (스케일링 건강보험 급여화 시행 1년 후 치과의료소비자의 인식도 및 만족도 조사)

  • Lee, Bo-Geun;Lee, Jung-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.185-193
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    • 2016
  • Objectives: The purpose of the study was to examine the recognition and satisfaction of dental care customers after 1 year national health insurance coverage of dental scaling. Methods: A self-reported questionnaire was completed by 477 dental care customers in Gyeongbuk, Busan, Yangsan, and Gyeonggido from July 18 to September 30, 2014 after receiving informed consents. The questionnaire consisted of general characteristics of the subjects(5 items), subjective awareness of oral health(4 items), recognition of scaling(5 items), and recognition and satisfaction of scaling health insurance(5 items). Data were analyzed using SPSS version 20.0 program. Results: Those who recognized the national health insurance coverage of dental scaling accounted for 80.1 percent and 47.2 percent of them got the health insurance coverage via media advertisements. Those who received the scaling service by health insurance coverage accounted for 73.8% and 66.2% of them were very satisfied with the service. Among the customers, 91.8% were satisfied with scaling health allotment. There was a statistical significance between scaling health insurance and subjective oral condition recognition(p<0.01). Through the health insurance coverage scaling service, the oral health in Korea will improve much. Conclusions: The expansion of health insurance coverage of scaling service will provide the universal oral health care for all people. Owing to low cost service, people will actively try to come in contact with public health service in the future.

Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center (민간의료보험이 암 환자의 의료이용과 의료비에 미치는 영향: 일개 암전문의료기관의 우리나라 주요 암종을 중심으로)

  • Lim, Jin-Hwa;Choi, Kui-Son;Kim, Sung-Gyeong;Park, Eun-Cheol;Park, Jae-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.329-335
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    • 2007
  • Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

The Comparison of Computerized Tomography Utilization between before and after Coverage of Medical Insurance (전산화 단층촬영의 의료보험 급여전후 촬영건수 비교)

  • Suh, Shin-Il;Kim, Han-Joong;Park, Eun-Cheol;Sohn, Myong-Sei;Kim, Dong-Kee
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.121-133
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    • 1998
  • We analyzed volume changes in the computerized tomography(CT) and the magnetic resonance imaging(MRI) utilizations. These two volumes are comparative because CT has been covered by the Medical Insurance from the beginning of 1996, however, MRI has not been covered up to now. We investigated 80 hospitals which afforded a facility of CT by the end of 1994. For the comparison of CT utilization, we selected two periods. The first period was from January to June of 1995, in which CT had not been covered by the Medical Insurance and the second period was from January to June of 1966, in which CT had been covered. The information we obtained were characteristics of hospitals, patients numbers per month, monthly uses of CT and MRI, and payments of CT claims, etc. After the Medical Insurance coverage, the number of CT uses per 1,000 patients were increased from January to March, however, was decreased from April to June in 1996 compared to the same periods of 1995. the number of CT uses in clinics were large than those in tertiary hospitals. The number of CT uses in small cities were larger than those in big cities. On the other hand, the number of MRI uses per 1,000 patients did not changed from January to May and was increased from June in 1996 compared to the same periods of 1995. These results showed the substitutional relationship of CT and MRI uses. After the insurance coverage for CT, the utilization of CT was increased because patients payed less than before. However, insurers restricted the payments to the CT claims. This impact might explain the substitutional relationship between CT and MRI.

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New Proposal of Private Insurance Program for Dementia Patients: Design of Sustainable Private Insurance Program in Korea

  • Park, Kun-Woo;Kim, Jhong Yun
    • 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.

Incidence Rate of Noise Induced Hearing Loss in Korean Youths Using National Health Insurance Data (건강보험 자료에 의한 우리나라 청소년의 소음성 난청 환자 발생 양상)

  • Jeon, Man-Joong;Choi, Eun-Ju;Sakong, Joon
    • The Journal of Korean Society for School & Community Health Education
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    • v.14 no.2
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    • pp.93-112
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    • 2013
  • Objectives: This study was conducted to investigate the incidence rate of noise-induced hearing loss (NIHL) in Korean youths using the National Health Insurance Data Methods: We obtained the case of NIHL with the National Health Insurance Data and calculated the incidence rate of NIHL after classifying them by year (from 2005 through 2008), age, gender, birth cohort. Results: The age-adjusted incidence rate by year of NIHL per 100,000 population increased by 40.6% from 13.8 persons in 2005 to 19.4 persons in 2008, which showed a increasing trend every year. In particular, the incidence rate per 100,000 population among the adolescents (15-19 years of age) shot up by 78.2% from 8.7 persons in 2005 to 15.5 persons in 2008. According to the incidence rate by birth cohort of NIHL, the birth cohorts showed the gradually increase in incidence rate as time passed by. Adolescents in early 20s (20-24 years of age) had a higher incidence rate than teenage and men had a higher incidence rate than women. Conclusions: The results suggest that incidence rate of NIHL in Korean youths has rapidly increased among adolescents. Therefore, it is required to educate adolescents about the risk of hearing loss due to noise, establish program to prevent NIHL among adolescents and provide them with health education on hearing loss prevention.

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Moon Jae-in Government Health Policy Evaluation and Next Government Tasks (문재인정부의 보건의료정책 평가와 차기 정부의 과제)

  • Tchoe, Byongho
    • Health Policy and Management
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    • v.31 no.4
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    • pp.387-398
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    • 2021
  • Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

Long-Term Care Utilization among End-of-Life Older Adults in Korea: Characteristics and Associated Factors (생애말기 노인의 장기요양서비스 이용 특성과 영향요인)

  • Yoon, Nan-He;Kim, Hongsoo;Kwon, Soonman
    • Health Policy and Management
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    • v.26 no.4
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    • pp.305-314
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    • 2016
  • Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

Factors Affecting the Insured Organizations Participation in Decision Making Process in Health Insurance Policy Committee (건강보험정책심의위원회 가입자 단체의 의사결정 참여에 영향을 미치는 요인)

  • Han, Joo-Sung;Kim, Chang-Yup
    • Health Policy and Management
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    • v.27 no.4
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    • pp.336-346
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    • 2017
  • Background: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. Methods: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. Results: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. Conclusion: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.