• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.8-16
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• 2021

This article aims to introduce the inception and operation of the COVID-19 International Collaborative Research Project, the world's first coronavirus disease 2019 (COVID-19) open data project for research, along with its dataset and research method, and to discuss relevant considerations for collaborative research using nationwide real-world data (RWD). COVID-19 has spread across the world since early 2020, becoming a serious global health threat to life, safety, and social and economic activities. However, insufficient RWD from patients was available to help clinicians efficiently diagnose and treat patients with COVID-19, or to provide necessary information to the government for policy-making. Countries that saw a rapid surge of infections had to focus on leveraging medical professionals to treat patients, and the circumstances made it even more difficult to promptly use COVID-19 RWD. Against this backdrop, the Health Insurance Review and Assessment Service (HIRA) of Korea decided to open its COVID-19 RWD collected through Korea's universal health insurance program, under the title of the COVID-19 International Collaborative Research Project. The dataset, consisting of 476 508 claim statements from 234 427 patients (7590 confirmed cases) and 18 691 318 claim statements of the same patients for the previous 3 years, was established and hosted on HIRA's in-house server. Researchers who applied to participate in the project uploaded analysis code on the platform prepared by HIRA, and HIRA conducted the analysis and provided outcome values. As of November 2020, analyses have been completed for 129 research projects, which have been published or are in the process of being published in prestigious journals.

• Journal of Society of Preventive Korean Medicine
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• v.13 no.3
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• pp.113-126
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• 2009

Objective : This research aimed to investigate and analyze the opinions of Oriental Medical Doctors (O.M.D.) on covering herbal medicines into National Health Insurance scheme. Methods : Structured questionnaires were e-mailed to the O.M.D.s listed on member's DB of the Association of Korean Oriental Medicine. Collected data were analyzed with the SPSS 12.0 program. Results : The insurance coverage for herbal decoctions was supported by 80.8% of the responders, the median reasonable price for daily herbal decoctions was \9,517, the minimum price median of daily herbal decoctions considering its costs was \8,080, and the daily technical fee median was \4,379. On health insurance coverage for herbal decoctions, O.M.D.s were specially considering the standardization of herbal medicines. Conclusion : In this study, majority of O.M.D.s assented to health insurance coverage for herbal decoctions, but considered standardization of herbal medicines and optional prescription fee. It needs to prepare plan for insurance coverage of herbal decoctions that reflect the character of oriental medicine and oriental medical institutions.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.1
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• pp.25-41
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• 2022

Background & Objectives : As the government of South Korea implemented policies to strengthen health insurance coverage, the health insurance benefit for raw herbal medicines has been promoted. This study investigated the current status of the herbal medicines coverage in the Japanese national health insurance to secure reference data for the design of herbal medicines coverage in South Korea. Methods : Literature review was conducted to collect and analyze the history and current situation on herbal medicines coverage in the Japanese health insurance system. To supplement the contents not presented in the documents, on-site interviews were conducted at the medical institutions and pharmacies that prescribed or prepared herbal medicines in Tokyo, Japan. The contents of the survey included the background and progress of the herbal medicines coverage, the status of herbal medicines use, the payment system, and the safety management of herbal medicines. Results : Since the introduction of health insurance in the 1960s, Japanese insurance system has covered herbal medicines, and so far, it has been maintained without any additional restrictions. When the raw herbal medicines are prescribed to outpatients, the preparation fee is set higher than that of other medicines, but overall payment regulations and systems for herbal medicine are generally the same as other medicines. Conclusions : The case of Japan can be a useful references and implications for national health insurance policy on herbal medicines in south Korea.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.1-16
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• 2009

Objectives: To study the standard herb prescriptions based on the specific names of the sick and wounded for the application of Eastern Medicine Health Insurance. Methods: We selected 678 herb prescriptions from the eleven Eastern medical books recognized by the Ministry for Health of Korea and then researched the concrete opinions of Korean Oriental Medicine Societies (KOMS) on those herb prescriptions from July 31, 2006 to August 31, 2006. Results and Conclusions: KOMS said that 80 herb prescriptions must be included and 26 herb prescriptions must be excluded. They also said that the proper numbers of the specific names of the sick and wounded for the application of Eastern Herbal Medicine Health Insurance were 20-29 and the proper range of herb prescription change was within 30 percent.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.91-94
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• 2024

For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda's health sector.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.3
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• pp.1-12
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• 2019

Objectives : Korean national health insurance data is a useful real-world data representing whole medical bills submitted to Health Insurance Review Agency. This study aims to understand recent benefit trend of insurance herbal preparations for treating bronchiectasis(disease code J47) utilizing insurance data. Methods : We reviewed national health insurance claims data from 2013 to 2017 which have main diagnosis or sub diagnosis code of J47 and with the record of prescribing insurance herbal medication. Frequency analysis was performed to analyze the most frequently prescribed prescription. Results & Conclusions : Both the number of claims statement(770 to 1,746cases) and patients(266 to 484) of insurance herbal preparations increased considerably from 2013 to 2017. Top 10 preparations based on the number of claims statement were 'Samso-eum', 'Yeonkyopaedok-san', 'Socheongryong-tang', 'Bojungikgi-tang', 'Hyangsapyungwi-san', 'Yijin-tang', 'Saengmaek-san', 'Jaeumganghwa-tang', 'Ojeok-san' and 'Gungha-tang'. Top 10 preparations based on the number of patients were 'Samso-eum', 'Socheongryong-Tang', 'Saengmaek-san', 'Yeonkyopaedok-san', 'Haengso-tang', 'Hyangsapyungwi-san', Yijin-tang', 'Jaeumganghwa-tang', 'Bojungikgi-tang' and 'Hyeonggaeyeongyo-tang' in respectiv order. Claims of top 10 frequent preparations occupied more than 60% of total claims. We hope this finding to be utilized as basic data for future research of evidence-based bronchiectasis treatment utilizing Korean traditional medicine.

• Journal of Preventive Medicine and Public Health
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• v.25 no.4 s.40
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• pp.333-342
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• 1992

The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations eon the 1990 Finance Report of the self-employed health insurance programs. Both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would be integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.387-391
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• 2007

Fibrosing mediastinitis is a rare disease that is characterized by the proliferation of dense fibrous tissue of the mediastinum. The pathogenesis of fibrosing mediastinitis is unknown in most cases. However, histoplasmosis, tuberculosis, autoimmune disease, radiation therapy, and other idiopathic fibroinflammatory diseases have been implicated in some cases. Most clinical features are related to an obstruction or compression of the mediastinal structure. Fibrosing mediastinitis is often progressive and occurs diffusely throughout the mediastinum. We encountered a case of fibrosing mediastinitis of a very focal lesion without evidence of mediastinal involvement. The condition was confirmed by biopsy and graft bypass surgery was performed because of SVC syndrome.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.14-19
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• 2016

Background: This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions. Methods: This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service. We identified developments over the 5-year time period and analyzed the level of regional imbalance regarding cardiovascular surgery through the relative comparison of relevance indexes between cardiovascular and other types of surgery. Results: The relevance index was high in large cities such as Seoul, Daegu, and Gwangju, but low in regions that were geographically far from the capital area, such as the Gangwon and Jeju areas. Relevance indexes also fell as the years passed. Cardiovascular surgery has a relatively low relevance index compared to key types of surgery of other fields, such as neurosurgery and colorectal surgery. Conclusion: This study identified medical service use imbalance between regions for cardiovascular surgery. Results of this study demonstrate the need for political intervention to enhance the accessibility of necessary special treatment, such as cardiovascular surgery.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.4
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• pp.61-72
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• 2022

Objectives The purpose of this study was to analyze the Chuna manual therapy usage status after the application of Chuna manual therapy health insurance. Methods This study analyzed the health insurance data (2019-2021). From April 2019 to December 2021, monthly data were collected by simple Chuna, complex Chuna (own expense 50%), complex Chuna (own expense 80%), and special (dislocation) Chuna. Results The major results are as follows. First, in hospital-level medical institutions, simple Chuna and complex Chuna (own expense 50%) occupied a similar proportion. In clinic-level medical institutions, simple Chuna occupies the largest proportion. Second, the amount of use decreased in all medical institutions after September, which is thought to be the result of restrictions on Chuna manual therapy health insurance. Conclusions Therefore, it is necessary to conduct research by receiving more detailed data onr Chuna manual therapy health insurance. Through this, an improved policy of Chuna manual therapy health insurance should be discussed.