• Title, Summary, Keyword: national health insurance coverage

Search Result 194, Processing Time 0.049 seconds

The Effect of Reform of New Diagnosis-Related Groups on Coverage of National Health Insurance (신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향)

  • Choi, Jung-Kyu;Kim, Seon-Hee;Chang, Cheong-Ha;Yoon, Jong-Min;Kang, Jung-Gu
    • Health Policy and Management
    • /
    • v.30 no.2
    • /
    • pp.178-184
    • /
    • 2020
  • Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

Parents' recognition and attitudes toward national health insurance coverage of sealant by dental hygienist (치아홈메우기의 건강보험 급여화와 치과위생사 시술에 대한 학부모의 인식 및 태도)

  • Kim, Yun-Jeong
    • Journal of Korean society of Dental Hygiene
    • /
    • v.15 no.6
    • /
    • pp.1099-1105
    • /
    • 2015
  • Objectives: The purpose of this study was to investigate parents' recognition and attitudes toward national health insurance coverage of sealant by the dental hygienists. Methods: A self-reported questionnaire was filled out by 329 elementary school children parents in G metropolitan city and N city from July 11 to 27, 2015. The questionnaire consisted of general characteristics of the subjects, recognition and attitudes toward national health insurance coverage of sealant and sealant by the dental hygienist, and recognition toward national health insurance. The data were analyzed by a descriptive analyses, multiple regression and logistic regression analysis using SPSS 12.0 program. Results: Recognition of national health insurance coverage was 2.52 times higher in high school and 4.97 times higher in recognition toward purpose of sealant. Factor affecting recognition of national health insurance was subscription of private health insurance, recognition of sealant treatment by dental hygienist (DH) and recognition of national health insurance coverage of sealant. Attitude toward sealant treatment by DH was positive in experience of sealant, recognition of sealant treatment by DH and experience of sealant treatment by DH. Factor affecting satisfaction on the sealant by DH was recognition of sealant treatment by DH and recognition of purpose of sealant. Conclusions: To increase national health insurance coverage of sealant, it is necessary to expand positive public relations of sealant by the dental hygienist.

Recognition about national health insurance of dental scaling in industry accident injury patients (스케일링 건강보험 급여화에 대한 산재환자의 인식도)

  • Lee, Hea Shoon;Lee, Kyung Hee
    • Journal of Korean society of Dental Hygiene
    • /
    • v.13 no.4
    • /
    • pp.561-568
    • /
    • 2013
  • Objectives : The purpose of this study is to examine the recognition and needs on the national health insurance coverage of scaling in industry accident injury patients. National health insurance coverage of dental scaling will start in September, 2013. Methods : Subjects were 649 industrial injury patients and they completed self-reported questionnaire. Data were analysed using SPSS version 20.0 for percentage, chi-square test, t-test, ANOVA, post-hoc Scheffe test, and Pearson's correlation coefficient. Results : Recognition on national health insurance coverage of dental scaling was not fully known to industrial injury patients (24.5%). Highly educated and high income workers seemed to recognize national health insurance coverage of dental scaling (p<.001). Recognition for national health insurance coverage of dental scaling revealed a significance (r=.576, p<.001). Most of the industrial injury workers thought that 50,000 to 100,000 Korean Won of dental scaling fee is reasonable. The coverage of dental scaling should be more than twice over 20 years old. Conclusions : It is necessary to encourage the patients to take regular dental scaling checkup and make them know the health insurance coverage of scaling. The preventive oral health care may improve oral health care and quality of life.

Dental technician's recognition of national health insurance coverage of denture (노인틀니 건강보험 급여화에 대한 치과기공사의 인식도 조사 연구)

  • Kang, Wol;Lim, Hyung-Tek
    • Journal of Technologic Dentistry
    • /
    • v.34 no.4
    • /
    • pp.423-431
    • /
    • 2012
  • Purpose: The purpose of this study was to examine the recognition of dental technician's about including denture into the coverage of the national health insurance. Methods: This study carried out self-administered questionnaire survey from June 10, 2012 to June 20 by having research subjects as 230 dental technician. Except 22 copies with incomplete response, 208 copies were used as the materials of final analysis. Results: The recognition of dental technician on the national health insurance of denture was 48%, but there was a low recognition on the details. The rates of dental technician who approved of the inclusion of denture into the coverage of the health insurance respectively stood at 59%. Conclusion: The coverage of the health insurance should be extended to dental medicine in a manner to satisfy dental technicians, dental service providers and receivers. Also, further studies for the extending coverage of the details are needed.

The cognition of denture fabrication activities and the costs in National Health Insurance for elderly denture (노인틀니 국민건강보험의 틀니제작행위 및 비용에 관한 인식)

  • Yu, Chin-Ho;Nam, Sang-Yong;Kim, Ji-Hwan;Nam, Kwan-Woo;Lee, Sun-Kyoung
    • Journal of Technologic Dentistry
    • /
    • v.38 no.4
    • /
    • pp.327-342
    • /
    • 2016
  • Purpose: The purpose of this study was to investigate the cognition of denture fabrication activities and its cost in National Health Insurance for elderly denture. Methods: A self-administered questionnaire was completed by 41 dental laboratories' owner who was research subjects of HIRA(Health Insurance Review & Assessment Service)'s policy research for elderly denture in 2011. The questionnaire consisted of general characteristics of the subjects, dental technicians' knowledge of national health insurance coverage of elderly denture, job-related changes after national health insurance coverage of elderly denture including validity of denture fabrication activity classification and the cost for each service. Each question was measured by Likert 5 point scale or frequency. The collected data were analyzed by SPSS 16.0. Results: Most of the research subjects had been fabricating national health insurance coverage denture(92.7%), also had ample knowledge of national health insurance coverage denture for elderly. Job-related changes after national health insurance coverage of elderly denture revealed marginal differences in the quality. The validity of fabrication activity classification of resin based complete denture was $3.71{\pm}1.023$ by Likert 5 point scale. Conclusion: The goal of national health insurance for elderly denture is to promote elderly's health and well-being. To fabricate denture is a very important part of the denture treatment. For this reason, denture fabrication activity classification and the cost analysis plan should be duly reflected in the policy of national health insurance for elderly denture.

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
    • /
    • v.16 no.2
    • /
    • pp.185-193
    • /
    • 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.

Is the Utilization of MID Services affected by the Implementation of Insurance Coverage?: Based on Claim Data of a General Hospital (MRI 보험급여 적용이 진료이용량에 미치는 영향 : 한 종합병원의 청구자료를 중심으로)

  • Kim, Seon-Hee;Kim, Chun-Bae;Cho, Kyung-Hee;Kang, Im-Ok
    • Health Policy and Management
    • /
    • v.18 no.2
    • /
    • pp.1-18
    • /
    • 2008
  • As medical insurance had been implemented for Magnetic Resonance Imaging (MRI) from January 1, 2005, this study investigated whether there had been any change in the amount of the medical care utilization of patients who undertook MRI before and after the insurance coverage, and was to examine factors affecting the amount of medical care utilization of MRI. Data were collected from patients who undertook MRI before and after the insurance coverage for a year at a general hospital in Kyeanggi-do. $X^2$ and t-test were used for the analysis of their general characteristics, the number of MRI, and its medical costs before and after the insurance coverage, and hierarchical multiple regression analysis for the factors affecting the amount of the medical care utilization of MRI. The results of this study were as follows. First, the number of MRI after the insurance coverage was significantly decreased. Second, there was no significant difference in the total medical costs of MRI after the insurance coverage, but a significant difference was found in patient's share of medical costs. Third, six variables were found to be affecting the amount of the medical care utilization of MRI, and the variables showed to lead the number of MRI decrease after the insurance coverage. These six factors explained 21.4% of the total number of MRI. As MRI had been covered by insurance, the use of MRI and patient's share of the costs were deceased, but the total medical costs were not affected. Reasons for that could be found in that MRI insurance, different from the case of CT insurance coverage, was allowed not to cover some items and the kinds of diseases subjected to the insurance coverage were extremely limited, lowering insurance prescription rate. In addition to that, the average medical cost of MRI was not changed after the insurance coverage. Therefore, as future measures for the MRI insurance, coverage, it should be considered to allow insurance coverage to no coverage items and to expand the scope of benefit coverage, or to lower patient's share of the costs. Furthermore, researches should be done to explore how recipients will act and how suppliers will react if the coverage is expanded, including expanding the scope of coverage and reducing patient's share of the costs, as well as to conduct research on its economic analysis according to case mix.

The Effect of Private Health Insurance Coverage Reduction on the Korean Medicine Utilization (실손형 민간보험의 비급여 보장축소가 한방의료이용에 미친 영향)

  • Park, Minjung;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
    • /
    • v.19 no.3
    • /
    • pp.57-66
    • /
    • 2015
  • Objective : Private health insurance coverage in Korean medicine has been reduced since October 2009 for preventing unnecessary utilization. The aim of this study is to identify how private health insurance coverage reduction affects on the Korean medicine utilization. Method : We analyzed the Korea Health Panel data from 2008 to 2012. Panel negative binominal regression model was used to analyze the relationship between private health insurance coverage reduction and utilization of outpatient service. Panel tobit regression analysis was used to identify the relationship between private health insurance coverage reduction and health expenditure of outpatient service. Results : Private health insurance coverage reduction significantly dropped both utilization and health expenditure of outpatient service by 9%, 9.22% respectively. In addition, therapeutic utilization significantly decreased up to 10%. Conclusion : Private health insurance coverage reduction seems to have an effect to reduce both utilization and the health expenditure of Korean medicine outpatient service. This effect was more noticeable in the therapeutic utilization. Thus, more elaborate policy will be needed to prevent unnecessary utilization of Korean medicine.

The socioeconomic impact of Korean dental health insurance policy on the elderly: a nationwide cohort study in South Korea

  • Seo, Hyewon;Lee, Bo-Ah;Lim, Hyunsun;Yoon, Joon-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
    • /
    • v.49 no.4
    • /
    • pp.248-257
    • /
    • 2019
  • Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

Dental hygienist's recognition of national health insurance coverage of toothbrushing instruction (칫솔질 교육 건강보험 급여화에 대한 치과위생사의 인식)

  • Gkuk, Jung-Suk;Lee, Jae-Ra
    • Journal of Korean society of Dental Hygiene
    • /
    • v.12 no.4
    • /
    • pp.751-758
    • /
    • 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.