• Title/Summary/Keyword: Insurance Purchasing

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Price Analysis of Therapeutic Materials for General Spinal Surgery by the Type of Wholesalers (병원의 구매대행업체 유형별 치료재료 청구가격 비교: 일반척추수술 재료를 중심으로)

  • Byeon, Jinok;Lee, Juhyang
    • Health Policy and Management
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    • v.30 no.3
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    • pp.409-417
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    • 2020
  • Background: It is well known that the distribution of therapeutic materials is very complex. However, it is not easy to demonstrate the concrete problems caused by distribution channels empirically. The purpose of this study was to investigate the differences in the price of therapeutic materials according to the type of purchasing agency and the way in which medical institutions purchase therapeutic materials. Methods: This study compared the claimed prices and the maximum allowable prices for the items of therapeutic material used for general spinal surgery. Results: Ilsan Hospital, which purchased directly without a purchasing agent, had the lowest claimed prices, followed by a large professional purchasing agency, a foundation-related purchasing agency, and a general purchasing agency. In addition, the difference between the claimed prices and the maximum allowable prices according to the purchase type was larger in the expensive treatment materials, and in the case of the lower price treatment materials, it tended to converge to the maximum allowable prices. Conclusion: National health insurance spending for therapeutic materials are to be affected by the distribution channels of them. We proposed several ideas to rationalize the expenditure such as classification of therapeutic materials on the basis of price or other criteria.

Factors and Trends Associated with Purchasing Multiple Private Health Insurances in Korea (우리나라 가구의 민간의료보험 과다가입 현황과 관련요인)

  • Lee, Hye-Jae
    • The Journal of the Korea Contents Association
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    • v.22 no.1
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    • pp.601-610
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    • 2022
  • Although the number of people insured by private health insurance in Korea is steadily increasing, the household burden or the status of multiple purchasing for private health insurance has not been addressed. In this study, data of the 2011-2018 Korea Health Panel Survey was used to examine the purchasing trend of Korean households' private health insurance. Households with more than three private health insurance per household member were defined as the 'poly-purchases'. The logit model was applied to analyze factors associated with poly-purchase of private health insurance using 2018 cross-sectional data. From 2011 to 2018, the number of insurances purchased by Korean households increased (4.0 to 4.6), the number of insurances per capita increased (1.3 to 1.6), and the proportion of the poly-purchasing households increased (5.2% to 10.8%). As a result of logit analysis, the probability of poly-purchasing was increased when the household head was a woman, with a high level of education and income, and when the job of the household head was a service or sales. Poly-purchasing was less likely when the family was subsidized with Medical Aids and suffered with more chronic diseases. The results of this study serve basic evidence for establishing policies regarding private health insurance, such as establishing the relationship between public and private insurance.

Analyzing the Customers' Intentions of Purchasing Weather Index Insurance (지수형 날씨보험 가입의향에 대한 분석)

  • Park, Ki-Jun;Hwang, Jin-Tae;Cho, Jae-Rin;Kim, Baek-Jo;Kim, In-Gyum
    • Journal of Environmental Science International
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    • v.23 no.2
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    • pp.171-180
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    • 2014
  • This study provides the empirical results of the customers' necessity and intentions of purchasing weather index insurance using survey of asking the customers' recognition about weather insurance. In this article, we discovered that not only the customers' past experience of loss but also the extent of damage and the effects that change in weather would have on their firm are positively related to an intention to purchase weather index insurance. In addition, the level of premiums was significantly higher for the highly-intended group of willing to purchase weather index insurance than the comparison group.

Consumer's Satisfaction of Insurance Consumption: Focusing on Self-determination Theory (소비자의 보험소비만족에 관한 융합연구: 자기결정성 이론을 중심으로)

  • Sim, Hyeon Jeong;Kim, Minjung;Choe, Hyuncha
    • Journal of the Korea Convergence Society
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    • v.9 no.5
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    • pp.157-169
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    • 2018
  • The purpose of this study is to investigate the effect of voluntary purchasing motives on insurance consumer satisfaction. The purpose of this study is to investigate the direct and indirect effects of insurance consumption satisfaction including psychological needs of consumers that induce voluntary purchase motivation based on psychological self-determinism theory. The research hypotheses and models were verified through structural equation analysis using online surveys of 1,225 insurance consumers. As a result of the study, the satisfaction of insurance consumption is increased when purchasing by voluntary purchase motive, in which consumers perceive the necessity of purchasing themselves. The positive perception of insurance consumption autonomy and insurance consumption environment increases the motivation to purchase voluntarily, Respectively. Through this study, it is suggested that excessive marketing of insurance companies and self-confidence of insurance consumers may hinder insurance consumption satisfaction and education of consumption attitudes of financial consumers to raise awareness of autonomous rights and responsibilities of insurance consumers.

Is the Single-Insurer a Powerful Purchaser?: In Case of Indonesia (단일보험자는 강력한 구매자인가: 인도네시아 사례를 중심으로)

  • Kim, Yanghee;Byeon, Jinok
    • Health Policy and Management
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    • v.30 no.2
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    • pp.151-163
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    • 2020
  • This study reviewed primary care purchasing issues of the Indonesian single-insurer, BPJS-K, in the context of triangular power relations between the government, the insurer, and the providers, and considered its challenges of purchasing as the national single-insurer. Some literature reviews and interviews with Indonesian stakeholders and residents were used to describe the historical and social contexts of Indonesian healthcare and social health insurance systems especially focusing legal and institutional status of BPJS-K and primary care provision and delivery conditions in remote areas. Though BPJS-K directly belongs to the presidential office of Indonesia, it has limited power in terms of purchasing as a single insurer. Mainly it was due to the lack of primary care resources, Ministry of Health's strong power as the regulator and provider, and BPJS-K's powerlessness against monitoring and quality of care assessment. Ambiguous accountability was another issue among the insurer and the Ministry of Health. This created confusions in primary care provision. It is suggested that each agencies' accountability should be obvious in terms of legal, political, and social contexts.

Factors Influencing the Purchase of Indemnity Private Health Insurance among the Elderly People Aged 65-75 (65-75세 노인의 실손형 민간의료보험 가입 영향요인)

  • You, Chang Hoon;Kang, Sungwook;Ha, Ho-Soo;Kwon, Young Dae
    • Korea Journal of Hospital Management
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    • v.24 no.1
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    • pp.48-56
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    • 2019
  • Purpose: As an interest in the elderly medical expenses increases, elderly people are increasingly purchasing indemnity private health insurance. Authors tried to investigate factors of having the indemnity private health insurance among the elderly people aged 65-75 years. Methods: We conducted panel logit regression analysis on 2,465 subjects as of 2016 using Korean Health Panel from 2010 to 2016. The dependent variable was whether to enroll in the indemnity private health insurance. The explanatory variables included socio-demographic characteristics, economic factors, health status, and health behaviors. Findings: As a result of the analysis of factors of purchasing indemnity private health insurances, it was analyzed that people with larger family, educated, pensioner, high household income or no disability were more likely to have indemnity private health insurance. Practical Implications: Considering the results of this study, the factor of purchasing indemnity private health insurance among elderly people were more likely to be their economic than demographic characteristics such as sex, age, and marital status. Policy makers should make efforts to reduce the burden on the elderly medical expense and to improve equity of medical use through institutional improvement such as raising age limit and lowering premium of indemnity private health insurance and expansion of public health insurance.

The determinants of purchasing private health insurance among middle-aged and elderly Korean adults (중.고령자의 민간의료보험 가입 여부의 결정 요인)

  • Yoo, Ki-Bong;Cho, Woo-Hyun;Lee, Min-Jee;Kwon, Jeoung-A;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.17 no.3
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    • pp.23-36
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    • 2012
  • Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

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The Function of Strategic Purchasing and Its Application to the Korean National Health Insurance System (의료보장제도 운영에 있어서 전략적 구매의 개념과 한국 제도에의 적용)

  • Kim, Duck-Ho;Chung, Seol Hee
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.504-516
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    • 2018
  • Many countries have tried to reform financing systems toward UHC and paid attention to the function of strategic purchasing. This study was performed to examine theoretical foundations and the function of strategic purchasing. And we examined the functions of strategic purchasing in Korea based on the framework proposed by Preker(2005). For this purpose, we reviewed literature related to purchasing. we defined the strategic purchasing as strategic activities to provide health care services people need within a given budget, which is carried out by certain organizations, purchasing organizations. These activities include selecting appropriate providers, designing and operating the payment system, setting the price, and determining the target populations and their needs etc. The relationships among government, purchasers and healthcare providers can be explained by the principal-agent theory. In addition to Preker's framework, we emphasized the importance of the infrastructure such as decision making support systems, information systems, health care resource management systems, or expenditure monitoring systems. The National Health Insurance Service and the Health Insurance Review & Assessment Service play major roles in performing strategic purchasing.

The Determinants of private health insurance purchasing decisions under national health insurance system in Korea : The expanding of private health insurance market, for the better or worse (민간의료보험의 선택에 영향을 미치는 요인 : 민간의료보험 활성화에 대한 함의)

  • Yoon Tae-Ho;Hwang In-Kyung;Sohn Hae-Sook;Koh Kwang-Wook;Jeong Baek-Geun
    • Health Policy and Management
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    • v.15 no.4
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    • pp.161-175
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    • 2005
  • Since the introduction of mandatory health insurance in In, the Korean national health insurance(KNHI) has grown rapidly. In 2004, about $96.9\%$ of the total population are covered by the KNHI and the remaining $3.1\%$ by the Medical Aid program. Despite national health insurance system in Korea, private health insurance market has grown rapidly. In 2004, the size of the private health insurance market was estimated at 6,568 billion won. The purpose of this study Is to identify the factors that determine the purchasing decisions of supplementary private health insurance under mandatory national health insurance system in Korea. The data from n04 Busan Health Survey were analysed for the Purpose. The variables in this study are demographic factors, health status and health behavioral factors, health care systemic factors, and socioeconomic factors. For statistical analyse, we used logistic regression. The Findings show that female, economically active age group(especially 35-49 years), persons with better health status or experience of health screening test are more likely to purchase private health insurance. And higher household income and expenditure, higher education level are more associated with the increased probabilities of private health insurance purchases. This results imply that the expanding of private health insurance market could widen the gap between the have and have-not in terms of equal health care accessibility.

Impact of the Purchasing Price Reimbursement System for Insurance Drugs upon the Health Insurer's Financial Situation (실거래가상환제의 건강보험재정에 대한 영향)

  • Jeong, Hyoung-Sun;Lee, Eui Kyung;Kim, Eun Jung;Ryu, Gun-Chun;Song, Yang Min;Kim, Sun-Ju
    • Health Policy and Management
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    • v.15 no.3
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    • pp.40-59
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    • 2005
  • The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer's financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by $1.53\%$ on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer's financial situation given that the current compulsory separation between doctor's prescribing and pharmacist's dispensing is irrevocable.