• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.185-209
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• 2014

While the local health insurance and the employment-based insurance were integrated in July 2000, the insured is divided into employment-based insured and the local insured and the relevant premium has been applied to both groups. The health insurance premium having the feature of social solidarity has to be determined depending on income, that is, the ability to pay in accordance with the principles of social insurance. While employment-based insurance premium has been determined depending on the earned income, the local insurance premium for the local insured has been determined by scoring gross income(evaluated income), property and possession of automobiles. A variety of improvement approaches has been implemented including introduction of the employment-based insurance premium ceiling system (2002) and the change of property scoring system for the local insured (2006). However, the health insurance system which was merged in 2000 has been implemented up to now without significant change even though there were lots of socio-demographic change including increase of income level and the population structure such as low birth and aging. In other words, it is required to implement the premium rating system securing the income-based equity. Nevertheless, it was inevitable to apply the diverse rating standards in the early stage because it was very difficult to verify the income of the self-employed. Although the income verification rate was significantly increased from 23% in 1989 to 44% in 2010, the irrational standards including property, automobiles, living standard and activity rate have been still applied to the local insured because it is difficult to secure the validity of insurance premium rating system and it severely lacks of security. This paper investigated whether the current insurance premium rating system for the local insured imposing the premium on the basis of 'gender' and 'age' complies with the basic human rights secured by the current Constitution of the Republic of Korea with respect to the practical and theoretic irrationality of insurance premium rating system and standards for he local insured. In accordance with the analysis results, this paper proposed the approach to improve the system.

• Journal of the Economic Geographical Society of Korea
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• v.17 no.1
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• pp.114-128
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• 2014

This study is the analysis on the labor migration between 16 provinces in experienced employees' sector by using the employment insurance statistics of 2008 to 2011. In wage workers of Korea, all of regular and some of temporary employees subscribe to the employment insurance and among these, about 40-50% career workers have moved their jobs every year. Targeting these, first I perform cluster analysis to explore the spatial boundaries of intra and inter-regional labor migration, and second measure the regional linkages extracting the inter-regional migrants. As results, the clusters of labor migration are similar to 5+2 Mega-regional Economic Zones. However, in the regional linkages between clusters, Seoul-metropolitan area has a great influence to other regions in inflow and outflow.

• Journal of dental hygiene science
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• v.17 no.4
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• pp.323-332
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• 2017

This study aimed to investigate the factors influencing the decision on whether to receive regular oral check-ups among the national health insurance beneficiaries with income and aged over 20 years in Korea. This was a cross-sectional study, using the data from the 2014 6th Korea National Health and Nutrition Examination Survey (KNHANES VI-2), conducted by the Korea Centers for Disease Control and Prevention. The final sample included 2,843 subjects who participated in the health examination survey and oral check-ups. The IBM SPSS Statistics ver. 20.0 was used for the statistical analysis, based on the complex sampling design. The Rao-Scott chi-square test was used to verify the difference in the distribution of independent variables with regard to oral check-ups. The binary logistic regression analysis was used to determine the influencing factors. The ratio of beneficiaries who received oral check-ups was less than half of those who received medical examinations. The Rao-Scott chi-square test, revealed significant differences in the age group (p<0.05) of the predisposing factors, toothache within a year (p<0.001), untreated dental caries (p<0.001) of the need factors, personal income level (p<0.001), educational level (p<0.001), type of medical insurance (p<0.001), and private health insurance (p<0.01) of the enabling factors. In the binary logistic regression analysis, factors influencing oral check-ups were age group, personal income level, educational level, toothache within a year, and untreated dental caries. These findings show a variety of factors influencing the utilization of regular oral check-ups.

• The Journal of the Korea Contents Association
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• v.9 no.4
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• pp.265-274
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• 2009

This study aims at examining the actual condition of recognition of dental caries(ACRDC), presenting a scheme to improve the recognition, and providing basic data necessary to prevent oral diseases, Dental caries (DC) which one of the three most important chronic diseases in Korea. A survey was conducted on ACRDC for about 390 people twenty and over who visited dental clinics for dental treatment 336 questionnaires with exception of omitted answer were used for statistical analysis. Many of them had never heard of DC and most of them failed to recognize it. People who experienced DC had a dental clinic as a main information channel and they were significant differences in those obtaining information through other channels(p=0.008). Univariate logistic regression analysis for effects on ACRDC demonstrated that possibility of subjects in their twenties recognizing DC more accurately than those in their forties Odds ratio(95% confidence Interval) was 2.06(1.16-3.66)(p=0.000), with the possibility of professionals recognizing the disease more accurately than those with other kinds of occupation 5.49(2.52-11.93)(p=0.000), showing statistically significant relevance. As for medical security, possibility of work insurance being related to more accurate recognition of dental caries than others was 1.95 (1.03-3.71)(p=0.003), with the possibility of subjects whose dental state was very good recognizing dental caries more accurately than those whose dental state was very bad 6.40(1.57-26.03) (p=0.002), showing statistically significant relevance. For prevention of DC, an education through experts working at a dental clinic are necessary for those in their twenties and over, who were other than professionals, who were insured for medical security via other than work insurance, and whose dental state was bad.

• KDI Journal of Economic Policy
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• v.12 no.3
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• pp.47-69
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• 1990

The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.

• The Journal of the Korea Contents Association
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• v.21 no.3
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• pp.314-323
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• 2021

The purpose of this study is to analyze the status of medical service use of foreigners living in Korea by their nationality and types of national health insurance. As of 2018, 1,058,886 people were extracted from the qualification DB, excluding people whose insurance premium is missing. The data analysis showed that nearly 78% of foreigners with national health insurance used medical services and the countries with the largest number of users were China, Vietnam, and the United States. The total cost of treatment per capita was highest in the United States regardless of hospitalization and outpatient. The number of medical treatments per person, and the medical expenses of outpatients & inpatients services were highest among the regionally-insured and the length of stay per person was highest among the workers' dependents. Lastly, it was found that Chinese and regionally-insured received much more benefits than other groups compared to the premium they pay. After July 2019, foreign nationals residing in Korea for six months or longer are obligated to enroll in the national health insurance program. Since the latest data was in 2018, the result did not properly reflect the current situation, but it is meaningful that it made basic data for future comparative analysis.

• Journal of Nutrition and Health
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• v.54 no.2
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• pp.179-198
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• 2021

Purpose: This study examined general characteristics, health status, accessibility to medical services, health-related quality of life, dietary behavior, and energy and nutrient intakes of the elderly at different levels of food security utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Methods: The elderly subjects (1,721 males and 2,271 females) were divided into 3 groups (secure, mildly insecure, moderately/severely insecure) according to their food security levels. Health and nutrient status was determined using energy intake, nutrient density, the prevalence of insufficient nutrient intake, dietary behavior, and health status. Results: The elderly with food insecurities had a lower self-evaluated health status and a higher prevalence of physician-diagnosed chronic diseases such as arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis for males, and hypertension, stroke, arthritis, and osteoarthritis for females. The associated financial burden was the major reason for not accessing medical services in the food insecure group. Furthermore, the food insecure group had a higher risk of impaired health-related quality of life compared to the secure group. The proportion of subjects with an energy intake below the estimated energy requirement was higher in the food insecure group and a significantly higher prevalence of insufficient intake was observed for all the nutrients (proteins, vitamin A, vitamin B₁, vitamin B₂, niacin, vitamin C, calcium, and iron) assessed in this study compared to the food secure group. Conclusion: This study suggests that food insecurity poses a challenge to the health and nutritional status of the elderly population in Korea and needs proper management. It would be helpful to develop food and nutrition assistance programs to ensure the food stability of the elderly population and assure quality to address gaps in their nutrient intake.