• 제목/요약/키워드: public health insurance

검색결과 1,072건 처리시간 0.026초

국내 학부 보건관리학과의 교육과정 분석연구: 취득면허·자격과의 관계를 중심으로 (Curriculum Analysis on Health Management Schools in Republic of Korea: Focusing on Relationship with Licence and Certification)

  • 이유리
    • 보건행정학회지
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    • 제28권1호
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    • pp.23-34
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    • 2018
  • Background: This study aims to conduct curriculum analysis on health management schools focusing on relationship with licence and certification in Republic of Korea. Methods: Possible employment field, licence and certification as well as curriculum were collected from the home page of 30 health management schools. The subjects and credits of curriculum were analyzed using descriptive statistics. Main subjects by areas were drew using categorization and ranking within qualitative methods. Comparative analysis was conducted for checking relationship between main subject and possible employment field, licence and certification. Results: First, major employment fields after graduation were public health officer, general hospital and clinic, and National Health Insurance Service. Possible licence and certificate were hospital administrator, medical recorder, health education specialist, and medical insurance specialist. Second, total graduate credits were 133.9 including 79.0 for major education, 30.5 for of general education, and 30.5 for elective courses. Third, main subjects were reviewed by areas including basic medicine, health management, hospital business & management, medical records & information, insurance billing & assessment, healthcare marketing & tourism, and health education. There were highest number of subjects on health education area among 8 categories. By subjects, many health management schools open health law, medical terminology, introduction to public health, and biostatistics. Relationship between main subjects and possible employment field, licence and certification in health management schools was strong. Conclusion: It is necessary to review curriculum and for improving educational quality in health management schools. Also, development of curriculum standards for courses in health administration and introduction of accreditation system can be considered.

지역의료보험(地域醫療保險) 재정지출(財政支出)의 결정요인(決定要因) (Determinant Factors for Expenditure of the Medical Insurance Program for Self-Employeds)

  • 감신;박재용;예민해
    • Journal of Preventive Medicine and Public Health
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    • 제28권1호
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    • pp.153-174
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    • 1995
  • This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

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우리나라 당뇨병 환자의 지료 지속성 및 이에 영향을 미치는 요인 (Continuity of Care of Patient with Diabetes and Its Affecting Factors in Korea)

  • 윤채현;이신재;주수영;문옥륜;박재현
    • Journal of Preventive Medicine and Public Health
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    • 제40권1호
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    • pp.51-58
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    • 2007
  • Objectives : The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. Methods : We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. Results : The average continuity of care in the entire population of 1,498,327 patients was $0.89{\pm}0.17$ as calculated by MFPC and $0.92{\pm}0.16$ by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. Conclusions : The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.

Annual Endovascular Thrombectomy Case Volume and Thrombectomy-capable Hospitals of Korea in Acute Stroke Care

  • Eun Hye Park;Seung-sik Hwang;Juhwan Oh;Beom-Joon Kim;Hee-Joon Bae;Ki-Hwa Yang;Ah-Rum Choi;Mi-Yeon Kang;S.V. Subramanian
    • Journal of Preventive Medicine and Public Health
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    • 제56권2호
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    • pp.145-153
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    • 2023
  • Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

국민건강보험공단 표본코호트 DB를 이용한 스케일링 보험급여화 전후 실태조사 (Evaluation of national health insurance coverage of periodontal scaling: A nationwide cohort study in Korea)

  • 김영택;이재홍;권혜인;이중석;최정규;김동욱;최성호
    • 대한치과의사협회지
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    • 제54권8호
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    • pp.604-612
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    • 2016
  • The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

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농촌 독거노인들의 사회적 지원과 생활만족도 (Social Support and Life Satisfaction of Living Alone elderly in Rural Area)

  • 김영순;윤희정;권진희;문효정;이성국
    • 농촌의학ㆍ지역보건
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    • 제27권1호
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    • pp.65-78
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    • 2002
  • This study was conducted to identify the social support to living alone elderly in some rural communities and the level of life satisfaction. For the purpose of this study, face-to-face interviews and questionnaire were performed with 315 old people(male 43 and female 272) aged over 65 living alone in rural communities covered by 14 community health posts within Gyeongsangbuk-do Province randomly selected. The followings are summaries of findings; The average score of support from their children was $4.29{\pm}2.73$ out of 8. Variables that showed a significant difference were religion, level of living, type of medical insurance, frequency of meeting with children, time taken from houses of children by usual means of transportation, and subjective health status. It was found that the score of support from children was high for the elderly who had a religion, a good level of living, benefit from medical insurance, a high frequency of meeting with children, or a good subjective health status, or who resided close to their children's houses. The level of the support from friends and relatives showed a significant difference depending on the subjective health status, of which the average score was $4.13{\pm}2.61$ out of 8. The average score of the level of life satisfaction was $6.83{\pm}4.24$(male $7.60{\pm}4.09$ and female $6.71{\pm}4.26$) out of 17. Male elderly showed the higher level of life satisfaction than female elderly. Variables that showed a statistically significant difference in the level of life satisfaction were religion, level of living, medical insurance, hobby, children, disease, subjective health status, and ADL. That is, the level of satisfaction with life was found to be higher for the elderly who had a religion, a good level of living, benefit from medical insurance, a hobby, children, no diseases, or a good ADL, or who thought that they are healthy. The regression analysis with support from children as a dependent variable showed that the level of support from children was higher for the elderly who had a good level of living, frequency of meeting with children, or a good subjective health status. The regression analysis with the level of support from friends or relatives was higher for old people who had a good level of living. The regression analysis with the level of life satisfaction as a dependent variable showed that the factors which related to the level of satisfaction were sex, religion, level of living, hobby, ADL, and subjective health status. That is, it was found that for male elderly who had a religion, a good level of living or a hobby, or who thought that they were healthy, the level of life satisfaction was higher.

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의약분업이 건강보험 급여비에 미친 영향 (Impact of the reform for separation between prescribing and dispensing of drugs upon financial situation of the National Health Insurance)

  • 정형선
    • 보건행정학회지
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    • 제16권2호
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    • pp.117-134
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    • 2006
  • Korean health care system introduced the reform for separation between prescribing and dispensing of drugs (SPD reform) in the latter part of the year 2000. The objective of this paper is to look at what change this reform has brought about in the financial situation of Korean public health insurance scheme, particularly in terms of insurance benefit outlay. Since the inception of the reform is a development of more than five years ago, its impact on the finance situation would now start to become apparent. Hypothesis is set in this study for each of three components of drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. In terms of the classification of health care services by mode of production, the impact of the SPD reform is confined mainly to the last two among three drug reimbursement fields including inpatient department, out-patient department and pharmacy. Pure impact of the SPD reform was estimated to be more or less than 1.7 trillion won, 13.1% of the total outlay of the Nation Health Insurance in 2001, and more than 2.0 trillion won, 14.9% of the total outlay of the Nation Health Insurance in 2003. Both dispensing fees for the pharmacists, which had been newly introduced on occasion of the SPD reform, and larger share of expensive drugs in the medicines prescribed by doctors were confirmed to be main drivers of the augmentation of drug reimbursement.