• Health Policy and Management
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• v.11 no.2
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.

• Journal of Korean society of Dental Hygiene
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• v.15 no.3
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• pp.353-361
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• 2015

Objectives: The purpose of the study is to investigate the level of knowledge and screening review rates of dental health insurance claims in dental hygienists. This analysis will provide the educational information to the dental hygienists. Methods: A self-reported questionnaire was completed by dental hygienists in Jeonbuk from December 17, 2012 to January 24, 2013. The questionnaire was distributed by ordinary mail or direct visit. Except incomplete answers, 350 data were collected and analyzed. The study instrument was adapted from the structured questionnaire by Hong and Yoo. The questionnaire consisted of education experience of health insurance management, subjective and objective knowledge, insurance screening review, and need for health insurance education. Data were analyzed by SPSS 12.0 program. Cronbach alpha in the objective knowledge on health insurance rate criteria was 0.836 and this was a reliable figure. Results: The subjective knowledge level of dental insurance was higher in the senior dental hygienists. Subgingival curettage was the lowest percentage of correct answers in the objective knowledge. In recent six months, higher review control rate was shown in the higher claim for health insurance and insurance screening review. Conclusions: The majority of the respondents had lower level of knowledge of health insurance claims. The continuous education of dental health insurance will be necessary in the dental hygienists.

• Journal of Korean society of Dental Hygiene
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• v.12 no.4
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• pp.751-758
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• 2012

Objectives : This study aimed to seek the national health insurance coverage and the efficient direction of toothbrushing instruction and to contribute to establishing policy as auxiliary data, targeting 373 dental hygienists who are working in some areas of Jeonnam. Methods : A research method was questionnaire survey by individually self-administration method. Results : It was indicated to agree to the national health insurance coverage of toothbrushing instruction in the better understanding and cooperation level with toothbrushing instruction, in case of carrying out toothbrushing instruction, and in the higher age group. Conclusions : There will be a need of allowing the national health insurance coverage to be formed in the direction at which the dental service providers and the dental service consumers can be satisfied, by being performed a comprehensive and sufficient research for this.

• Proceedings of the Safety Management and Science Conference
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• 2013.04a
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• pp.557-564
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• 2013

This study investigates the delay declaration of the traffic insurance accident which is focused on a business truck causing the traffic insurance accident. The type of the delay declaration is classified as 15 types and it differs in level of payment of insurance money. It is most important that the support policy of government and the self-help of related business to reduce the delay declaration and pursue progressive solution. Moreover, it is essential not only introducing the strict regulation system but also adapting the various victim protection system.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

• The Korean Journal of Health Service Management
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• v.10 no.1
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• pp.143-154
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• 2016

Objectives : The aim of this study was to validated the effectiveness of the information gap in work and daliy life satisfaction. Additionally, this study attempted to verify the mediating effect of self-esteem. Methods : The study examined 327 students who participated in a study on the PSWCI 1st Wave by KCOMWEL. Data were analyzed through descriptive statistics using the reliability test in SPSS 22.0 Ver. Moreover, hypothesis testing was analyzed with covariance based on structure equation modeling (CB-SEM) using Amos 21.0 Ver. Results : The low information gap has a positive effect on satisfaction with work and daily life. Additionally, self-esteem also has a positive effect on each satisfaction measure. However, self-esteem does not have a mediating effect between information gap and each satisfaction measure. Conclusions : The results of the study found the factor of effect on effect factor on beneficiary's satisfaction of industrial accident compensation insurance. Therefore, new ways need to be found that reduce the information gap and increase self-esteem.

• Korean Journal of Community Nutrition
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• v.13 no.2
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• pp.244-252
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• 2008

The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, $x^2$-test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.

• Journal of Korean society of Dental Hygiene
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• v.16 no.1
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• pp.61-67
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• 2016

Objectives: The purpose of the study is to investigate the knowledge of the dental health insurance standard of elderly denture in the dental hygienists. Methods: A self-reported questionnaire was completed by 183 dental hygienists in Busan and Gyeongnam. The questionnaire consisted of general profiles of the subjects(11 items) and 10 items of the dental health insurance standard of the elderly denture including subject of spplication, application method, calculation of range, and temporary denture. Each question was measure by Likert 5 points scale. Cronbach's alpha was 0.936 in the study. The data were analyzed using SPSS 20.0 program. Results: The knowledge of the dental health insurance standard on the elderly denture in the dental hygienists was high in cognition of the renewed standard change(p<0.001), individual career(p<0.05), and recognition of the current standard(p<0.05). Conclusions: It is continuously necessary to inform the dental hygienists of the knowledge of dental health insurance standard. The web-based program for the dental health insurance education should be provided continuously for the dental hygienists.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.7
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• pp.261-271
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• 2022

Over the last 20 years, the insurance industry in Vietnam has been rapidly growing with an average annual growth rate of 21%, one of the most active markets in Southeast Asia, raising the question of efficiency to managers, investors, and regulators. This article is one of the first research works using Data Envelopment Analysis combined with the Malmquist index over the period from 2016 to 2020 for 37 insurance firms in Vietnam to investigate the efficiency of this sector. The value-added approach is employed with total equity and operating expenses as inputs, finance income, and gross written premium as outputs. The findings reveal that most of Vietnam's insurance companies are operating quite effectively, and the non-life sector is more efficient than the life sector. There is also a regression in efficiency change, while there is a progression in technological change and total factor productivity change during the period examined. The goal of this research is to give a fundamental understanding of the overall efficiency of insurance firms in Vietnam, and help managers, investors, policyholders, and government agencies make better decisions regarding self-assessment, M&A activities, deregulation... Consequently, the insurance sector could improve in terms of efficiency and develop sustainably over time.

• Journal of Digital Convergence
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• v.11 no.10
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• pp.593-608
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• 2013

According to increasing number of injury claims, the challenge is reducing investigation of cases of injuries by selecting them more delicately, while also increasing the redemption rates and the amount of restitution. In this regards, we developed the fraud detection model for injury claims of self-employed insured by using decision tree after collecting medical claim data from 2006 to 2011 of the National Health Insurance in Korea. As a result of this model, subject types were classified into 18 types. If applying these types to the actual survey compared with if not applying, the redumption collecting rate will be increasing by 12.8%. Also, the effectiveness of this model will be maximize when the number of claims handlers considering their survey volume and management plans are examined thoroughly.