• Korea Journal of Hospital Management
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• v.27 no.3
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• pp.39-49
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• 2022

Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Korean Security Journal
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• no.32
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• pp.151-176
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• 2012

Government organizations (including police, prosecutor, and Financial Supervisory Service) and programs to uncover or prevent from insurance crime are not well developed. However, insurance crime are increasing among not only private insurances such as life insurance, indemnity insurance, and auto insurance but also public insurances including national health insurance and industrial accident compensation insurance. The damages of crimes are serious in both economical and ethical perspectives. Insurance crime deteriorates a current account of insurance companies and the leakages due to insurance fraud worsen loss ratio. Consequently, insurance crime increases customers' costs of insurance. For this reason, insurance companies stated to establish Special Investigation Unit(SIU) to detect insurance crime and fraud by themselves. However, organizational and operational efficiencies are limited. The purpose of this study is to examine the relationship between work environment factors, perception of insurance crime and job satisfaction among Special Investigation Units. Therefore, this study investigated the perception of work environments of Special Investigation Units. In addition, this study examined how their work environments and general perception of insurance crime influence their job satisfaction. In order test the purpose of this study, reliability test, exploratory factor analysis(EFA), multiple regression were employed. The results of this study suggested that clarity of insurance company, distress/difficulty of resolve, compensation, perception of work pressure are statistically significant on jab satisfaction among Special Investigation Unit in South Korea. This exploratory study expected to contribute to understanding of Special Investigation Unit, and their insurance crime prevention system. The results from this analysis will be examined in light of previous findings and policy implications discussed.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.195-217
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• 1985

A statistical analysis on the ratio of weight-for-height in insurance medicine was carried out in a total of 12,690 insured persons who were medically examined at the Honam medical department, Dong Bang life insurance company, ltd. from June, 1979 to February, 1984. The results were as follows: 1. The mean value of the ratio of weight-for-height(W/H ratio) was $102.3{\pm}11.3%$ in all males, and $105.2{\pm}103.6%$ in all females. The difference of the values between males and females showed statistical significance(P<0.001). The mean value of W/H ratio in all the insureds was $103.8{\pm}12.9%$. In each age group, the mean value of female was higher than that of male without exception(P<0.001). The mean value of both sexes in each age group showed gradual increase with age except for the age group over 50(P<0.001). 2. The incidences of the average weighted, overweighted and underweighted lives were respectively 91.6% in all males, 84.2% in all females(P<0.001); 7.9% in all males, 15.4% in all females(P<0.001); 0.5% in all males, 0.4% in all females(P>0.05). The incidences of average weighted, overweighted and underweighted lives in all the insureds were respectively 87.6%, 12.0% and 0.5%. The incidence of the average weighted lives in male in each age group was always higher than that in female with the exception of the age group below 19(P<0.001), whereas the incidence of the overweighted lives in male in each age group was always lower than that in female(P<0.05 in the age group below 19, P<0.001 in the other age groups). The incidence of average weighted lives of both sexes in each age group showed gradual decrease with age from the second to fifth decade(P<0.001), whereas the incidence of the overweighted lives of both sexes in each age group showed gradual increase with age from the second to fifth decade(P<0.001). 3. The relative frequency distribution polygons of W/H ratio of both sexes drawn in a pair on one coordinate plane revealed lying in juxtaposition each other horizontally and showed the shifting of female's polygon to male's one toward the direction of greater value of W/H ratio at a short distance which increased gradually with age. 4. Correlations between both sexes and among age groups relating to W/H ratios of the insureds seem to be a physiological phenomenon of body build and should be considered on the rating of the build. Author prepared a rating table of build based on the correlations above menthioned. Some gradients by sex and age in the rating table of build are organized; in female group, the ratings of 0, 30-50, 50-100 and 100-D are to calculate by the build with W/H ratio of 80-125%, $126{\sim}145%,\;146{\sim}165%$ and over 166% respectively in the age group of 29 or under, by the build with W/H ratio of $80{\sim}130%,\;131{\sim}150%,\;151{\sim}170%$ and over 171% respectively in the age group of $30{\sim}59$, and by the build with W/H ratio of $80{\sim}135%,\;136{\sim}155%,\;156{\sim}175%$ and over 176% respectively in the age group of 60 or over. In male group, the ratings of 0, $30{\sim}50$, 50-100, and 100-D are to calculate by the build with W/H ratio of $80{\sim}120%,\;121{\sim}140%,\;141{\sim}160%$ and over 161% respectively in all ages. Of under weighted lives, in both sexes, the ratings of 30-50 and 50-D are to calculate by the build with W/H ratio of $76{\sim}79%$ and under 75% respectively. The results of the ratings according to a rating table by author were as follows: The incidence of the ratings of 0, 30-50, 50-100 and 100-D showed no difference between male and female. The incidence of the ratings of 0(indicating the average weighted lives) showed gradual decrease with age and the incidence of the ratings of 30-50 and 50-100(indicating the overweighted lives) showed gradual increase with age. These results are thought to be considerably reasonable because the incidence of the builds in each age group is supposed to have no difference by sex and the incidence of the overweighted lives would increase with age.

• Health Policy and Management
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• v.21 no.4
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• pp.617-642
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• 2011

The purpose of our study is to analyze the determinants of the benefits of the long-term care insurance in Korea using 2008 and 2009 cross-sectional data. Per capita long-term care insurance benefits can be divided into home care services utilization rate, institutional care services utilization rate, per capita home care services benefits, and per capita institutional care services benefits, which are used as the dependent variables in our regression analysis. Admission rate and the ratio of the admitted to the applicant also used as the dependent variables. The results of our analysis show that the explanatory variables such as income level, needs for care, family type, access to the services, and regional characteristics are statistically significant to explain the dependent variables, the long-term care insurance benefits. The higher is the regional income and the more of the female residents, the more are the long-term care insurance benefits. The easier is the access to the services, the more are the insurance benefits. In the rural area, the level of the insurance benefits is relatively high. We propose that copayment rates of the long-term care insurance should be examined and monitoring on the over-use of the services should be done. Also preventive services and care by the family member should be expanded.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• 2007.11a
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• pp.48-53
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• 2007

A project manager of construction project must analyze risks which might happen during the construction phase and prepare a restoration method against the risks in order to get the successful project's accomplishment. Insurance is a representative kind of risk transfer method and an institution which prevents damages of the insured. In spite of increasing the ratio of construction insurance policy in the construction industry, project managers have regarded the insurance as a formal action in the budget through insurance companies' guides. These aspects make them not be able to valuate the reasonableness of premium rate and the real amount of the risks. This thesis is to present an improved method of construction insurance contract. Firstly, the status of the current construction insurance system have been anlyzed and the problems have been deducted. Secondly the development direction against the problems is presented in the research. Lastly, the procedure model is proposed for acquiring the resonable premium rate of insurance.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.38-47
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• 2020

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.25-36
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• 2020

Purpose: We analyzed the characteristics and differences in patients' medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.147-157
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• 2011

Purpose: This study was done to investigate factors affecting perceived financial burden of medical expenditures. Method: The participants were 2,024 inpatients who were enrolled in a survey on the benefit coverage rate of the National Health Insurance in 2006. The collected data were analyzed using t-test, ANOVA-test, Mann-Whitney-test, Kruskal-Wallis-test, Chi-square test and logistic regression. Results: The crucial factors for perceived financial burden were age, job, equivalence scale, ratio of annual family income vs medical expenditure, and private health insurance. Perceived financial burden was higher for people who were older, who were unemployed, whose medical expenditures were high compared to annual family income, whose index of family equalization was low and for those who had no private health insurance. Conclusion: The results of the study indicate a demand for system reform that will enable management of no-pay hospital bills in the National Health Insurance to decrease the medical expense of people in the low-income bracket.

• East Asian mathematical journal
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• v.38 no.5
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• pp.617-641
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• 2022

In this study, we first present a brief overview of the Korean general insurance market. We then explore the characteristics of the loss ratios of the Korean general insurance industry and apply Markov regime-switching methodology to model the loss ratios of these insurance companies by line of business based on changes in economic regimes. This study applies a number of confirmatory tests such as Zivot-Andrews test (2002), the Chow (1960) test and the Bai and Perron (1998) to confirm the presence of structural breaks in the time series of the loss ratios by line of business. Then, we employ Markov regime-switching methodology to model these loss ratios. We find empirical evidence that the loss ratios reported by insurance companies in Korea is characterized by two distinct regimes; a regime with high volatility and a regime with low volatility, except for vehicle insurance. Our analyses suggest that macro-economic conditions have significant explanatory effect on loss ratios but the direction of effect differs based on the line of business and the regime. Unlike previous studies that have applied linear regressions or divided the samples into different periods and then apply linear regressions to model loss ratios, we argue for the application of Markov regime-switching methodology, which are able to automatically distinguish the different regimes that may be associated with the movements of loss ratios based on differing economic conditions and regulatory upheavals. This study provides a more in depth understanding of loss ratios in the general insurance industry and will be of value to insurance practitioners in modelling the loss ratios associated with their businesses to aid in their decision making. The results may also provide a basis for further studies in other markets apart from Korea as well as for shaping policy decisions related to loss ratios.