• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.270-279
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• 2011

This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

• 건강소식
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• v.39 no.9
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• pp.18-19
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• 2015

학업 스트레스와 불규칙한 식습관으로 인해 10대 위염환자가 늘고 있다. 이는 국민건강보험공단의 '건강보험 진료비 지급' (2008~2012) 자료를 통해서도 드러나고 있는데, 그 결과를 보면 10대 위염환자 증가율이 전체 평균 3%의 두 배가 넘는 7.3%에 이르고 있다. 위염을 방치할 경우 위궤양 등 더 큰 병으로 발전할 수 있기 때문에 다음의 내용을 참고하여 위염으로부터 건강을 지킬 수 있도록 하자.

• The Korean Chronic Disease News
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• no.290
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• pp.12-12
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• 2005

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.663-683
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• 2015

The change of the population pyramid due to low fertility and rapid aging threatens the financial sustainability of National Health Insurance. We construct statistical models for prevalence rates and medical expenses using National Health Insurance Service (NHIS) sample cohort data from 2002-2013. We then project yearly expenditures and income of national health insurance until 2060 that considers various assumptions in regards to future population structure and economic conditions. We adopt a VECM-LC model for prevalence rates and the double exponentially smoothing method for the per capita co-payment of healthcare expense (in which the two models are institution-disease-sex-age specific) to project of national health insurance expenditures. We accommodate various assumptions of economic situations provided by the national assembly and government to produce a financial projection for national health insurance. Two assumptions of dependents ratios are used for the projection of national health insurance income to conduct two future population structures by the two assumptions of aging progresses and various assumptions on economic circumstances as in the expenditure projection. The health care deficit is projected to be 20-30 trillion won by 2030 and 40-70 trillion won by 2060 in 2015 constant price.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.1
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• pp.121-130
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• 2019

Automobile insurance medical expenses increased by 12% in year 2015 compared to year 2014. But the oriental medical service expenses in automobile insurance increased by 36% during the same period. In this paper the reason for the rapid increase of expenses for oriental medical service was analyzed using the method of decomposing medical expenses. As a result of analyzing 34,351,120 cases that were examined and completed during the period of 2014~2015, the number of oriental medicine patients increased by 27% and the medical expense per patient increased by 7%. The result of analysis showed that there was no significant change in service period per patient but medical expense per day increased by 7%. The increase in the number of patients receiving only oriental medical services was 32%. Increase in the number of patients receiving medical treatment and oriental medical services was 24% and the number of patients receiving medical treatment only decreased by 4%. There was significant increase in non standardized cost of oriental physical therapy which was one reason of the increase of the expenses. However, the most influential factor of the increase in the expenses of oriental medical services was the increase of the number of patients.

• Journal of agricultural medicine and community health
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• v.35 no.1
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• pp.77-88
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• 2010

Objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with hypertension, diabetes and dyslipidemia using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. Methods: The medical expenditure of hypertension, diabetes and dyslipidemia related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. Results: The medical expenditure attributable to overweight and obesity of hypertension were 456 billion won (men : 215 billion won, women : 241 billion won). Those of diabetes were 282 billion won (men : 148 billion won, women : 135 billion won), and of dyslipidemia were 17 billion won (men : 9 billion won, women : 8 billion won). Consequently, these costs corresponded to 33.3% of total medical expenditure due to hypertension, diabetes and dyslipidemia. Conclusions: We found a substantial medical expenditure due to overweight and obesity of hypertension, diabetes and dyslipidemia were very high. In order to reduce these costs, effective national strategies for prevention and management of overweight and obesity should be established and implemented.

• The Journal of the Korea Contents Association
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• v.20 no.3
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• pp.92-105
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• 2020

This study was aimed to identify factors affecting the purchase of indemnity private health insurance and analyze its effect on healthcare utilization by gender. This study analyzed data of the 2010-2016 Korea Health Panel Survey using panel logit model and panel regression model. Men were less likely to purchase indemnity private health insurance than women. Self-rated health and unmet need for healthcare in women were related to insurance purchases. In men, married people and residents of the metropolitan area were more likely to purchase. The indemnity private health insurance did not affect the women's outpatient expenses per visit, but for men it increased. The indemnity private health insurance significantly increased women's inpatient expenses per admission, but it did not affect men's inpatient expenses. This study confirmed gender differences in the factors affecting the purchase of indemnity health insurance and the impact of indemnity health insurance on healthcare utilization. This suggests that gender differences should be taken into account in private health insurance research and institutional operation.

• Information Systems Review
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• v.7 no.1
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• pp.275-295
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• 2005

Changes in business environment caused by globalization of the world economy and the beginning of the knowledge society forced hospitals to equip with tools for the enhanced competitiveness. In other words, hospitals must aim three targets such as acquisition of advanced medical skills and equipments, improvement of service level for patients, and achievement of superior managerial performance simultaneously. This study has been done to suggest a way to reduce the possibility of hospital bill claim reduction as an alternative for the achievement of superior managerial performance. If the reduction rate of hospital bill claim is high, it will put negative impact on the hospital's revenue stream and hospital's reliability. Thus, if they want to stay competitive, hospitals need to device ways to cut the reduction rate as much as possible. In this study, a prototype system has been developed and implemented to check the possibility to cut the reduction rate through deep analysis of causes of reduction. The prototype first developed utilizing data mining techniques and the relation rules algorithm. Then the prototype was tested its performance using the D hospital's live data.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.4 no.2
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• pp.57-62
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• 2003

In order to implement SGR in Korea, it is necessary to analyse the factors affecting the increase of Korea Medical Insurance Cost. GDP and MEI may substitute the diverse factors affecting the Medical Cost Uprise. In this article, the GDP and MEI influence on the rates of fee schedule is measured when we implement SGR System in Korea. The various cases are made to analyse the rates of fee change. In Korea, if we implement the SGR system successfully. we should make a considerate formula using GDP and MEI because the rate of change in GDP and MEI is much more bigger than that of U.S.

• 건강소식
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• v.36 no.5
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• pp.24-25
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• 2012

자궁근종은 우리나라 여성의 약 40%에서 발견되는 질환 중 하나다. 국민건강보험공단 건강보험정책연구원 자료에 따르면 과거 5년 사이 자궁근종 환자가 20% 이상 크게 늘어난 것으로 분석되었다. 자궁근종 진료인원은 2005년 19만 5,000명에서 2009년 23만 7,000명으로 매년 증가하고 있는 것으로 나타났고 2009년 실 진료비는 999억 원에 달했다. 이 중 20~30대 가임기 여성들의 환자 수가 계속해서 증가하는 추세이며, 30~40대 환자의 비율은 70%에 달해 여성들의 자궁근종에 대한 관심이 날로 높이지고 있다.