• Korean Journal of Social Welfare
• /
• v.56 no.3
• /
• pp.113-133
• /
• 2004

Although National Health Insurance(NHI) in the South Korea has guaranteed access to health insurance coverage to virtually all the people, a significant portion of out-of-pocket spending can create substantial financial burdens for some beneficiaries, particularly those with low incomes. Previous studies have estimated the magnitude of out-of-pocket spending by types of chronic illness or in- and out-patients. Prior estimates, however, have not given a complete picture of the impact of health care costs on lower-income populations. The result from this study shows that 20 percent of beneficiaries in the lowest-income quintile spent more than twelve percent of their household equivalent income out-of-pocket health services, whether they were enrolled in a Health care services or not. In comparison, the beneficiaries in the highest-income quintile level spent only 2 percent of their income out-of-pocket on health care. Also, the regression analysis suggests that age, household income, number of chronic illness, type of hospital in addition to the number of usage may affect the size of out-of-pocket spending.

• Health Policy and Management
• /
• v.20 no.1
• /
• pp.103-124
• /
• 2010

Objectives: The out-of-pocket payment (OOP) of the Industrial Accident Compensation Insurance (IACI) in Korea was investigated empirically in terms of its incidence, magnitude and factors influencing them. Methods: The subjects were sampled with stratified, randomized methods among medical institutions of which the number of monthly IACI claims exceeded its median as of May 2008. Out of 204 institutions selected, 118 institutions (57.8%) responded to this survey. A total of 24,826 episodes(2,457 inpatient and 22,369 outpatient episodes) were included in this analysis. The incidence and magnitude of OOP of IACI were calculated by characteristics of institution as well as patient. Factors that affected the incidence and magnitude of OOP were investigated through multi-level analysis. Results: The overall incidence of OOP of IACI was 9.9% (25.6% for inpatient and 8.2% for outpatient) and the percentage of OOP among total expenditures was 8.3% on average (7.6% for inpatient and 26.8% for outpatient); 25.2% at traditional oriental medicine hospitals, 9.5% at general hospitals and 2.5% at the industrial-accident-designated medical institutions. The incidence of OOP of IACI was influenced by hospital size, ownership, longer duration of designation (over 5 years) and length of stay. On the other hand, its magnitude was influenced by medium-sized hospital, public hospital, location of large city and length of stay. Extra charges for upper grade room which accommodates less than 4 patients and treatment by specialists were the leading contributors to the magnitude of OOP of IACI. Conclusion: The incidence and magnitude OOP of IACI varied in institution type and were influenced by both institutional and patient's factors. In order to achieve the goal of Industrial Accident Compensation Insurance, appropriate level of compensation, that is, no incidence of OOP, for accident and disease of workers, it is necessary to take measures to reduce incidence and magnitude of OOP.

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

• RED RIBBON
• /
• s.58
• /
• pp.20-21
• /
• 2004

정부는 고액의 치료비가 소요되는 희귀난치성 질환에 대해 본인일부부담금 산정특례로 지정하여 치료비의 $20\%$만 본인이 부담하는 특례를 주고 있다. 지난해까지 12개 질환에 대해서만 산정특례로 인정되던 것이 올해 1월부터는 에이즈를 포함하여 62개 질환으로 대폭 확대되어 많은 환자들의 경제적 부담을 덜게 되었다.

• Journal of Digital Convergence
• /
• v.15 no.12
• /
• pp.625-633
• /
• 2017

The purpose of this study is to investigate the effect of private insurance revenues and household spending on household income inequality. To this end, we conducted a concentration index and concentration curve analysis for the income level of medical panel survey data in 2015. The main results are as follows. First, the household income concentration ratio is 0.3580, which means that income is concentrated in the high income group, and the degree of inequality is considerably large. Second, although the portion of the private insurance benefits was small on the high-income household, it helped to strengthen the benefits concentration on this group. Third, the low income group has a large self-pay medical expense. Finally, the index of the income excluding the burden of the total medical expenses in the household income was 0.3676, so that even accounting for medical expenses, the income was concentrated in the high income class. Therefore, private insurance benefits and medical expenses were all contributing factors to the inequality of household income, and this study provides the essential materials for research and policy planning which could lead to the convergence of different fields.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.196-210
• /
• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• The Journal of the Korea Contents Association
• /
• v.13 no.11
• /
• pp.187-197
• /
• 2013

Objectives : The purpose of this study was to analyze the effect of outpatient cost sharing reduction on health care utilization of children under 6 years old. Methods : The data in this analysis was the health insurance claims data between August 2006 and July 2008. The study group was divided into two age groups, namely 0-5 years old and 6-10 years old. This study evaluated the impact of policy change on office visits per person and expenditure per visit. In order to do so, the double difference analysis is used. Results: The results showed that outpatient cost-sharing reduction has never really had a huge impact on office visits per person and expenditure per visit. Conclusions: This study showed that the outpatient cost sharing reduction for children under 6 years old policy is not working. Therefore, cost sharing of National Health Insurance by income class is needed.

• The Korean Chronic Disease News
• /
• no.288
• /
• pp.12-12
• /
• 2005

• The Journal of the Korea institute of electronic communication sciences
• /
• v.11 no.10
• /
• pp.1009-1016
• /
• 2016

In this study, an educational program was developed. The program can perform the claim for examination of medical expense, which is one of NCS Competence Unit Elements for hospital administration. Considering various coding to complex compute and process, VB.Net was employed for this development. For database, ACCESS Database was used because it is easy to learn and use. The learning effects by the developed program are expected to be as follows. First, the composition of medical expense can be understood by analyzing Medical history and then selecting insurance code according to the Standard of Medical Care Code. Second, unit cost per score can be learned according to hospital class. Third, selection of Column (medical materials) and Column II(medical practice) can classify items of additional ratio. Fourth, because patient's payment rate on hospitalization and meal expense and use of special equipment are differently applied, user can know patient's payment rate by type and can calculate it. Fifth, additional amount is the amount calculated by additional ratio of Column II(medical practice), and user can learn additional ratio according by insurance type and hospital class. Sixth, user can learn self-pay rate by hospital class and understand the process that self-pay amount and claim amount are calculated according by self-pay rate.

• Journal of dental hygiene science
• /
• v.15 no.6
• /
• pp.703-711
• /
• 2015

The high dental treatment cost has been considered as one of the major reasons for inappropriate dental treatment in Korea. The aim of this study was to investigate the opinions of expansion of National Health Insurance (NHI) in dental treatment fields not covered with NHI and buying private dental insurance. This survey was carried out targeting 266 adults from their 30s to 50s with convenience sampling. The higher orders in stress of dental treatment cost were orthodontic treatment, dental implant, prosthodontic treatment, and caries treatment not covered with NHI. The higher orders in needs of expansion of NHI were caries treatment not covered with NHI, prosthodontic treatment, and orthodontic treatment. The agreement percentages with age restriction in NHI were scaling 57.1%, denture 23.3%, implant 14.3%, respectively. The subjective oral health had impact on the stress of dental treamtent cost and expansion on NHI. Although only 8.3% subjects had private dental insurance, 68.4% of the subjects had positive opinions buying private dental insurance. The correlation coefficients between stress of dental treatment cost and buying private dental insurance were implant 0.408, caries treatment not covered with NHI 0.404, denture 0.394, crown and bridge 0.375, and orthodontic treatment 0.313. Expansion of NHI in dental treatment and development of private dental insurance was suggested to treat dental disease in appropriate time.