• 보건행정학회지
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• 제5권1호
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• pp.80-105
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• 1995

Assuming that we introduced integration of medical insurance society for self-employed, this study was conducted to examine effects and results after the integration and to research more effective method for integration. To assess effects and results of the finacial status of 266 insurance societies after intergration, the data were obtained from "The Medical Insurance Program for Self-Employeds Statistical Yearbook in 1992". The major finding are as follows : 1. Three alternative integration proposals were made. First alternative proposal was consisted of 232 medical insurance societies, second was 187, and third was 115. 2. As the results of average number of the insured per insurance societies of medical insurance program for self-employed every alternative proposal, first was 88, 119 persons, second was 108, 576, and third was 178, 967 from 76, 576 persons of present socienties. 3. It was true that the more average size of societies increased, the more average administration expenditure per 1, 000 insured reduced. 4. The average size of societies grew bigger, the rate of general expenditure to general revenue more improved. Also, the rate of benefits to contributions was changed for better. But if not to have had correct analysis and precise preparation for integration, effects and results of integration were always not optiized. 5. According to results of simple regression formulas, it was proved that the more the average size of societies was increased, the more result was advantaged. 6. The law of majority and the economy of scale were applied in this study, and it was necessary to analyze and assess effectiveness and efficiency of integration. Therefore, when the integration of medical insurance societies for self-employeds will be performed, it must be taken into consideration. Among three alternative proposals, third was showed more effective alternative than anothe, second was presented more ineffective result than present system. To achieve more effective and efficient integration of regional medical insurance societies throughout the result of the regression formula on present cost curve, it is necessary to operate well-integrated societies and to know appropriative countermeasures of present situation of each societies. Also, for integrating regional medical insurance societies, it is necessary to continue more deep research through practical model activity and to investigate the effective size and managed method of the societies.societies.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.294-302
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• 2017

Objectives: The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods: Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results: Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of selfreported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions: Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

• 대한한의학방제학회지
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• 제18권1호
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• pp.43-56
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• 2010

Objective : There is a growing need to expand or adjust insurance coverage of herbal prescriptions in National Health Insurance. The purpose of this study was to provide basic data for expansions or adjustments of 56 herbal prescriptions in the National Health Insurance. Method : We surveyed lists of 56 insurance-covered herbal prescriptions, non-covered company-produced herbal medicines and self-prepared herbal medicines in 531 traditional korean medical clinics by mail from 6/1/2008 to 12/9/2008. Result : Among the 56 Prescriptions, Ojeok-san was stocked in 66.7% of clinics (1st), Samso-eum ranked 2nd, Socheongnyong-tang ranked 3rd, Gumiganghwal-tang was 4th, Hyangsapyeongwi-san ranked 5th. Among the non-covered company-produced herbal medicines, Danggwisu-san ranked 1st, Gwakyangjeonggi-san ranked 2nd, Oryeong-san was 3rd, Bangpungtongseong-san was 4th, Maengmundong-tang ranked 5th. Among the self-prepared herbal medicines, Gongjin-dan ranked 1st, Soche-hwan was 2nd, Gyejibongnyeong-hwan was 3rd, Yeongsin-hwan was 4th, Palmi-hwan ranked 5th. Conclusions : It is reasonable to select frequently used company-produced or self-prepared herbal prescriptions in this stock rate survey for improvement of National Health Insurance coverage.

• 한국병원경영학회지
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• 제24권4호
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• pp.33-42
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• 2019

Purpose: many domestic welfare programs use the amount of health insurance premiums as a way of measuring individuals' income levels for administrative convenience. As health insurance reform has been made, we examines the income level is still appropriately measured by the health insurance premiums for the employment success package as one of domestic welfare program. Methodology/Approach: we investigate whether the upper limit of the premiums of the self-employed health insured is appropriate or not after healthcare reform, which currently calculated by multiplying the insurance premium of the employee based insured by the adjustment factor (1.2). Findings: we examined appropriateness of the adjustment factors by comparing the premiums before and after the healthcare reform by utilizing the national health insurance data as well as Korea Welfare panel data. We found that the new value of adjustment factor (1.0~1.1) is smaller than the current one (1.2). Practical Implications: to improve the equity between the employee and the self-employed insured after the health insurance reform, the adjustment factor should be lower.

• 한국직업건강간호학회지
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• 제21권3호
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• pp.247-257
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• 2012

Purpose: This study is designed to identify major factors that affect morale among staff of long-term care insurance in National Health Insurance Corporation. Methods: In order to collect the data, a survey was conducted by using the structured questionnaire based on 161 staff members of long-term care insurance of 50 long-term care operation centers, which were randomly selected by the table of random numbers in the whole centers of National Health Insurance Corporation from September 1 to 30, 2011. As for the data analysis, SPSS 18.0 was used to conduct the descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, mutiple regression, and path analysis. Results: The average point of morale was 3.37, and had a negative correlation with the job stress, while it had a positive correlation with the social support, professional identity, and self-efficacy. Job stress, social support, and professional identity have a significant effect on morale among the independent variables. These variables have significant effects on morale, and also have a positive effect on self-efficacy. The findings show that self-efficacy mediates the process of morale. Conclusion: In this study, the factor which influences the morale was identified. It turned out that the morale could be improved by reinforcing the professional identity, managing the health status as well as rotating the working place. As such, it expects both the improvement of long-term care insurance services outcome and its quality through the morale management.

• 한국치위생학회지
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• 제15권1호
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• pp.31-38
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• 2015

Objectives: The purpose of this study is to investigate the factors of oral health beliefs on scaling performance by national health insurance coverage in consumers. Methods: The subjects were 353 people living in Seoul, Incheon, and Gyeonggi-do from September 25 to October 20, 2013. They filled out the self-reported questionnaire after receiving informed consents. The questionnaire included 6 questions of general characteristics, 6 questions of oral health behavior, 6 questions of health insurance coverage, and 1 question of subjective oral health recognition. The oral health belief consisted of 6 questions of seriousness, 6 questions of susceptibility, 8 questions of barriers, 5 questions of benefit, and 3 questions of self-efficacy measure by Likert 5 scale. Cronbach's alpha in the study was 0.759. Data were analyzed using SPSS version 20.0 for frequency analysis, t-test, ANOVA, post-hoc Scheffe test, Pearson's correlation coefficient, and binary logistic regression. Results: The influencing factors of oral health belief model were Seriousness(${\beta}=0.091$), Self efficacy(${\beta}=-0.471$) and age(${\beta}=0.855$)(p<0.05). Those who had highly perceived seriousness and younger age tended to have probability of scaling performance. Higher self-efficacy tended to take more chance to have scaling performance probability. Conclusions: In order to cover the scaling by national health insurance, it is very important to notice the benefit of health insurance coverage of scaling to the consumers. National health insurance coverage enables the scaling practice to be easily accessible to the people. Easy access to scaling by low cost strategy can improve the oral health behavior.

• 노동경제논집
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• 제30권1호
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• pp.55-83
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• 2007

본 논문은 실직에 대비한 대출자가보험의 후생효과와 정부개입 필요성에 관해 분석하고 있고, 이 문제를 다루는 데 있어서 본 논문에서는 근로자가 오랜 실직기간으로 퇴직후 연금소득이 부족하여 대출상환을 못하고 정부로부터 최저소득 지원을 받게 되는 가능성을 전제하고 있다. 본 논문에서는 대출자가보험이 동태적 소비균등화 및 근로유인 강화 측면에서 긍정적 후생효과를 갖지만 대출상환 불능 가능성이 그 효과를 제약 할 수 있음을 보이고 있다. 또 대출상환 불능자에 대한 정부 지원이 민간부문의 대출자가보험을 유인할 수 있음을 보이고, 이에 따라 정부의 대출자가보험 공급 여지가 감소 할 수는 있지만 일정 부분 정부의 역할이 필요하게 됨을 보여주고 있다.

• 가족자원경영과 정책
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• 제14권4호
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• pp.263-277
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• 2010

The purpose of this study was to investigate levels of self-esteem and related variables among the elderly. The data is from the Korea Welfare Panel Study conducted in 2007. The data was gathered from 2077 elderly, over 65 years old, and was analyzed by Step multiple regression analysis. The major results were as follows. First, the overall level of self-esteem was in the middle range, with an average of 28.18 points. Second, self-esteem levels showed significant differences in terms of gender, age, education level, health, spouse, health insurance, job, monthly household expenses, national pension, assets, home ownership, satisfaction with spouse, satisfaction with leisure, satisfaction with social network, economic services, medical services, and other services. Finally, Model 1 showed meaningful influences from gender, age, education level, health, spouse, and health insurance. Model 2 showed meaningful influences from education level, health, spouse, health insurance, job, and national pension. Models 3 and 4 showed meaningful influences from education level, health, job, satisfaction of spouse, satisfaction with leisure, and satisfaction with social network. In other words, the factors that had the most significant impact on self-esteem were satisfaction.

• 의료법학
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• 제20권1호
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• pp.203-242
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• 2019

지방자치단체는 의료보장을 위해 2006년부터 국민건강보험제도 등 의료보장과 관련한 사회보험료를 지원하는 정책이 매월마다 시행되고 있다. 본 연구는 지방정부에서 노인세대 또는 저소득대가구 등의 국민건강보험료 등 공적 보험료를 지원하는 자치법규가 어떠한 내용으로 법규화되어 있는가의 특성 등에 대해 고찰하는 데 목적이 있다. 본 연구의 수행을 위한 방법으로서 국가법령정보센터의 웹사이트에 공표된 자치법규에서 조례와 조례규칙을 '건강보험료'의 검색어를 통해 검색한 결과를 통해 이루어졌다. 2019년5월 현재 제정된 조례는 201건이었는데, 광역지방자치단체는 17개 중에서 8개의 시도에서, 기초지방자치단체는 226개 중에서 193개의 시군구에서 제정되어 있으며, 조례 시행규칙은 전체 37건이 제정된 것으로 조사되었다. 이 중 조례의 경우 목적, 조례 제정시기, 사회보험료의 종류, 사회보험료의 지원 대상, 사회보험료 지원의 금액, 사회보험료 지원의 방법과 과정, 사회보험료 지원의 시기, 사회보험료의 재원 등으로 구성되어 있고, 이러한 조문 내용에 대해 분석하였다. 그리고 이러한 내용을 통해 정책적, 법적인 측면에서 논쟁이 될 수 있는 사안은 무엇인지에 대한 논의와 함께 개선 방향을 제시하였다.

• Journal of Preventive Medicine and Public Health
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• 제24권3호
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• pp.265-278
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• 1991

This study was to examine the effects of insurance coverage on the utilization of public health institutions and to identify the factors associated with the utilization. The data were obtained from household interview surveys conducted twice in Hwachun Gun, Kangwon Do. The time period covered in the first survey was December $17{\sim}31$, 1987, before the implementation of regional medical insurance for the self-employed, and that of the second survey was January 28 $\sim$ Febuary 11, 1990, after its implementation. Major findings emerged from the analysis can be summarized as follows (1) Medical care utilization of rural people markedly increased after they were covered by medical insurance. The insurance coverage increased the utilization of public health institutions as well, and this increase was mainly attributable to the utilization by chronically ill patients. (2) Between 1987 and 1990, the proportion of the utilization of public health institutions over whole medical care utilization decreased. But the proportion increased for chronically ill patients covered by regional medical insurance during the same time span. (3) The results of logistic regression suggested that the rural self-employed utilized public health institutions at an increased rate after they were covered by medical insurance. It was also indicated that the increase resulted from the utilization by chronically ill patients. (4) The relative importance of public health institutions for rural medical care decreased after the implementation of regional medical insurance. But considering that the utilization of public health institutions by chronically ill patients increased after insurance coverage, attention should be directed to improving the capability of public health institutions to control chronic degenerative diseases.