• Journal of dental hygiene science
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• v.8 no.2
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• pp.65-71
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• 2008

The purpose of this study was to examine people's awareness of health insurance in a bid to help improve the management of dental health insurance coverage. The subjects in this study were 1,036 people who included experts in that field and medical consumers. The findings of the study were as follows: 1. In regard to the demographic characteristics of the expert group including gender and age, the female experts outnumbered the males, as the former accounted for 84.7 percent. And the experts in their 20s made up the largest age group, followed by the 30-39 age group and those in their 40s. As to the demographic characteristics of the medical consumers, the rates of the men and women stood at 49.8 percent and 50.2 percent respectively, which were similar. By age, the largest number of the medical consumers were in their 20s, followed by in their 30s and in their 40s. 2. Concerning opinions on the procurement of finance for health insurance, many respondents in both groups agreed that the health insurance coverage should be enlarged by securing more finance, and that items involved in the coverage should be prioritized again. Regarding a means of securing financial resources, the experts placed the most emphasis on extended budgetary support from the government, followed by establishing a social security system and budget compilation by local governments. The medical consumers attached the most importance to extended budgetary backing from the government, followed by budget compilation by local governments and determining contribution according to income level. 3. As for general view of the dental health insurance, the experts believed that the amounts of copayment and self-payment by the insured were appropriate(2.47), and they found the number of benefitted items to be proper(2.29) as well. The medical consumers thought that the benefit percentage of the dental health insurance in the overall health insurance budget was appropriate(2.26), and they also considered the number of benefitted items adequate(2.16). But this group didn't give a lot of marks to the appropriateness of those things. 4. As to perception about the dental health insurance, both groups took a similar view of it. Specifically, they felt the strong need for a dental health insurance system. In terms of satisfaction level, both groups were dissatisfied with it, and there was a strong tendency for them to be discontented with the health insurance coverage.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.75-82
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• 2021

The purpose of this study was to review literature about private health insurance (PHI) schemes for Korean older adults published in Korea and abroad from 2015 to 2019, and to present the implications of the study and provide an overview of PHI utilization by Korean older adults. Nineteen quantitative academic research papers were selected and analyzed with respect to presentation time, research purpose, data source, and study design. Old age, low income, low education, and chronic disease were found to hinder enrollment in PHI schemes. Although the relationship between PHI and medical usage was not consistent, it was positively related to health outcomes such as subjective health status and health-related quality of life. Therefore, for PHI to fulfill the role of providing supplementary medical care for older adults with high medical demands, a national improvement policy should be developed to address the barriers that prevent older adults adopting PHI schemes, and empirical studies related to medical usages by and the health outcomes of older adults should be conducted in order to generate a basis for the use of PHI.

• Journal of Convergence for Information Technology
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• v.8 no.4
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• pp.9-14
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• 2018

The purpose of this study was to analyse the relationship between the characteristics of the patients who received oral antihyperglycemic drugs and their medical adherence in Korea. The study method was a cross-sectional study using the patient sample data of the Health Insurance Review and Assessment Service for 2016, and it was analyzed with 109 major components of diabetes drug. The medical adherence was slightly higher in male than female. The patriots & veterans(free) type had the highest medication adherence because they have low self burden to access medical institutions compared to other insurance types. It is expect that this study result will be used as a basic data to understand the burden of outpatients with health insurance and establish a policy to reduce of the self outpatients' burden with chronic diseases such as type 2 diabetes.

• 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.

• Journal of the Korean hospital association
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• v.34 no.1 s.293
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• pp.14-17
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• 2005

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.63-70
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• 2017

Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

• 방재와보험
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• s.111
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• pp.68-69
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• 2006

국내 만성 간질환의 큰 원인 중 하나인 C형 간염은 현재 B형 간염에 비해 감염율이 상대적으로 증가 추세에 있다. 이 중 30%가 간경변이나 간암으로 진행하므로 향후 큰 문제가 될 수 있는 병이다.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.215-230
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• 2005

The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.

• 한국노년학
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• v.30 no.3
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• pp.855-869
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• 2010

The purpose of this study is to identify how to efficiently integrate long-term care facilities into geriatric hospitals. We conducted a survey on the current operations of facilities and medical services of 2009 of 192 long-term facilities and 168 geriatric hospitals in Korea between October and November. Technical statistics and chi-square test were conducted on the collected data using the SPSS 13.0/Win program. There was a difference between the two facility types in terms of the co-payment levels of the food services. Both types selected the budget deficit as their major management problem. Ease of access and the surrounding environment were critical factors used to select the location of both types of facilities. Facility users benefited from the discounted co-payments of both facility types. However, facility users wanted more frequent visits and support from their family members during their stay at the facilities. It was discovered that users in the long-term care facilities stayed longer, that is until they died, compared to their counterparts in geriatric hospitals. The two types of facilities provided their services totally separately to users. Users of the two types of facilities are poorly supported and cared for by their families. This study suggests that setting reasonable service fees, paying caretakers, introducing an integrated facility, strengthening facility assessment standards, introducing the family doctor system, and introducing the handling of long-term care insurance by geriatric hospitals would allow the integration between long- term care facilities and geriatric hospitals to be beneficial.

• Journal of Korean Society for Atmospheric Environment
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• v.4 no.1
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• pp.58-70
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• 1988

대기오염이 건강에 미치는 영향의 유무를 알아보고 그 영향의 정도를 반영해 줄 수 있는 지표의 개발을 목적으로 우리나라 전역을 서울, 대도시, 중소도시, 농어촌 등 4개 지역으로 구분하고 의료보험대상자 3,922,027명에 대한 호흡기질환 외래수진률을 지역별로 비교해 보았다. 조사대상 질환군으로서는 다음 7가지의 호흡기질환을 채택하기로 하였다. 1) 결핵성 질환 2) 호흡기 및 흉곽내장기의 악성신생물 3) 급성호흡기 감염 4) 폐염 및 인플루엔자 5) 만성폐색성 폐질환 및 유사증 6) 진폐증 및 외인성의 기타 폐질환 7) 상기도의 기타질환 상기 질환으로 인한 외래수진에 관한 정보는 1983년 1월 1일 부터 12월 31일 사이에 제출된 보험의료비 청구서에 나타난 자료를 이용하여 수집하였으며, 그 분석을 통해 다음과 같은 결론을 얻었다. 1) 지역별 연간종합외래수진률을 비교해 본 결과 농촌지역에서 가장 낮은 수준을 나타내고 있는 질환은 조사대상 7개 호흡기질환군중 다음 4개 질환군이 해당되고 있다. (1) 결핵질환 (2) 호흡기 및 흉곽내장기의 악성 신생물 (3) 상기도의 기타질환 (4) 진폐증 및 외인성의 기타 폐질환 한편 이 종합외래수진률이 가장 높은 지역은 대도시 지역으로서 5가지 호흡기질환군의 수진률이 다른 지역에 비해 훨씬 높게 나타나 있다. 이와같은 결과는 의료보험환자들의 "외래수진률"을 이용하여 대기오염과 건강과의 관련도를 측정할 수 있는 "대기오염 - 건강" 지표의 개발이 가능할 것임을 뒷받침해 주고 있다. 그러나 가장 오염도가 높다고 예상되는 서울지역에서의 외래수진율이 대도시 지역보다 높지 않다는 것은 오염도와 외래수진률과의 관계에서 일관성있는 결과를 보여주지 못하고 있음을 뜻하는데 과거의 자료로서는 외래수진률만 가지고 대기오염과 건강과의 관계를 표시해주는 지표로 삼기에는 미흡함을 알 수 있다. 2) 월별 외래수진률의 경향을 보면 거의 모든 호흡기질환군에서 계절적인 특이성을 나타내지 못하고 있다. 단 이 경우도 농촌지역이 연중 계속 최하위를 유지하고 있는 질환군이 7개 대상질환군 중에 4개군에 달하고 있다. 3) 보험환자들의 "외래수진률"은 아직은 미흡한 점이 있으나 앞으로 "대기오염 - 건강" 지표로서 개발 활용할 가치는 있다고 볼 수 있으며 서울, 대도시, 중소도시, 농어촌 등 4개 지역에 대한 월별 외래 수진률을 다음 4가지 질환군에 대하여 계속 관측하여 그 경향을 분석할 것을 권장한다. (1) 호흡기 및 흉곽내장기의 악성 신생물 (ICD. 160-165) (2) 급성호흡기 감영 (ICD. 460-466) (3) 폐염 및 인플루엔자 (ICD. 480-487) (4) 만성폐색성 폐질환 및 유사증 (ICD. 490-496) 4) 외래수진률은 진료방식 즉, 투약기간의 장단등으로 인한 통원 (通院) 빈도 차이의 영향을 받게 되므로 지역별 병 $\cdot$ 의원의 보험환자 진료방식에 대한 비교검토가 요구된다.